Pancreatic duct stenting for prevention of acute post-manipulation pancreatitis in complicated cholelithiasis

OBJECTIVE: To evaluate the effectiveness of pancreatic duct stenting for prevention of acute post-manipulation pancreatitis in complicated cholelithiasis. MATERIAL AND METHODS: The study included emergency and urgent endoscopic transpapillary interventions in patients with cholelithiasis and no predictors of acute post-manipulation pancreatitis between January 2016 and May 2025. Patients were divided into two groups - with (main group) and without (comparison group) prophylactic pancreatic duct stenting. In both groups, mean age of patients, severity of mechanical jaundice, cholangitis, nature and number of surgical interventions were analyzed. We compared the incidence and severity of acute post-manipulation pancreatitis, necessary repeated endoscopic or surgical interventions, the number of patients requiring intensive care, ICU- and hospital-stay, as well as mortality. RESULTS: When excluding patients with well-known predictors, no significant decrease in the incidence of acute post-manipulation pancreatitis was recorded (4.7% in the main group and 5.5% in the comparison group). In most cases, acute mild post-manipulation pancreatitis was detected (3.4% and 4.5%, respectively), and all symptoms regressed under therapy without repeated endoscopic intervention. In the main group, repeated endoscopic intervention was required in 3.4% of patients, in the comparison group - only 1%. This slightly prolonged duration of treatment (11.7 and 10.3 days, respectively). CONCLUSION: Routine retrograde pancreatic duct stenting for complicated cholelithiasis in middle-aged men without recognized predictors does not significantly reduce the incidence of acute post-manipulation pancreatitis.