Therapeutic outcomes of prophylactic pancreatic stent placement for endoscopic papillectomy: a single-center retrospective study

Background Prophylactic placement of pancreatic stents for endoscopic papillectomy (EP) reduces the incidence of postprocedural pancreatitis, but there is ongoing debate about whether routine stent placement should be recommended. We aimed to evaluate the therapeutic outcomes of prophylactic pancreatic stent placement for EP. Methods This retrospective study included 65 patients who underwent EP for duodenal adenomas at Shenzhen People's Hospital between January 2020 and May 2024. The patients were divided into two groups: those who received prophylactic pancreatic stent placement and those who did not. Details of clinicopathological characteristics and therapeutic outcomes were collected and analyzed. Results The overall incidence of postprocedural pancreatitis was 15.4%, with a bleeding rate of 2.5%, and no cases of perforation. There was no statistically significant difference between the stent and non-stent groups in terms of bleeding (P = 0.485), perforation (N/A), length of hospital stay (P = 0.784), or costs (P = 0.585). However, the incidence of pancreatitis was significantly different between the groups: 8.7% in the stent group (4/46) vs. 31.6% in the non-stent group (6/19) (P = 0.029). Multivariate logistic regression confirmed pancreatic stent placement as an independent protective factor against post-EP pancreatitis (OR = 4.846, 95% CI [1.183–19.846], P  = 0.028). Conclusions Our data suggest that routine prophylactic pancreatic stent placement is beneficial for patients undergoing EP, both in terms of cost-effectiveness and reducing the incidence of postprocedural pancreatitis. However, large prospective studies are still needed to identify patients who would derive the greatest benefit from pancreatic stent placement after EP.