EFFICIENCY OF STENTING OF THE MAIN PANCREATIC DUCT IN PREVENTION OF POSTMANIPULATION PANCREATITIS FOR PATIENTS WITH BENIGN AND MALIGNANT PATHOLOGY

I.M. Sayfutdinov1, L.E. Slavin1,2, V.Yu. Muraviyov2,3, A.I. Ivanov2,3, M.K. Davliev1

¹Interregional Clinical-Diagnostic Center, Kazan

²Kazan State Medical Academy — Branch of the FSBEI FPE RMACPE MOH Russia, Kazan

3Tatarstan Cancer Center, Kazan

Sayfutdinov I.M. — Cand. Med. Sc., Head of Endoscopy Department of the Interregional Clinical-Diagnostic Center

12a Karbyshev Str., Kazan, Russian Federation, 420101, tel.: (843) 291-10-12, +7-917-249-66-88, e-mail: ISayfutdinov@mail.ru

Abstract. Between 2007 and 2017 years, after 1350 endoscopic transpapillary interventions, postmanipulation complications were observed in 37 cases (2.7%), of which acute pancreatitis was diagnosed in 20 patients (54% of cases). The results of 56 stenting of the main pancreatic duct were analyzed. Stenting of the main pancreatic duct was performed in the period 2009-2011 years in patients with acute pancreatitis, in the period 2012-2014 years in patients with a predicted high risk of postmanipulаtion pancreatitis at the end of transpapillary intervention, in the period 2015-2017 years preventively, before the papillosphincterotomy, after the primary cannulation of the pancreatic duct.

The results of main pancreatic ducts stenting for patients with benign pathology (major duodenal papilla stenosis, terminal (distal) part of the choledoch stenosis, choledoch stenosis, choledocholithiasis, chronicle and acute pancreatitis) ― 1098 manipulations was performed (81,3%), and malignant pathology of pancreatobiblary zone (pancreatic head cancer, bile ducts and major duodenal papilla cancer, gallbladder cancer, metastasis in lymph nodes of liver gates) ― 252 manipulations was performed (18,7%).

A high therapeutic and prophylactic effect was achieved, which reduced the incidence of acute postmanipulation pancreatitis from 4.6% in 2009-2011 years up to 1% in 2015-2017 years.

Key words: postmanipulаtion complications, acute pancreatitis, stenting of the main pancreatic duct, pancreatic head cancer, bile ducts and major duodenum papilla cancer, gallbladder cancer, metastasis in lymph nodes of liver gates.