A randomized comparison of 5Fr and 3Fr stents is less than conclusive.
Prophylactic pancreatic duct (PD) stenting lowers the incidence of post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high-risk patients. To compare two types of PD stents, researchers randomized 249 such patients to receive either a straight, unflanged 5Fr stent (2–3 cm long) or an unflanged 3Fr stent (8–10 cm long with pigtail). Patients with PD stricture toward the head of the pancreas and patients with severe chronic pancreatitis were excluded.
The rate of stent-placement failure was significantly lower in the 5Fr group than in the 3Fr group (0% vs. 9%). Study-defined 3Fr placement failure (i.e., failure to position the tip beyond the genu) led 11 of 133 recipients of 3Fr stents to be crossed over to the 5Fr…