Year 2017 / Volume 109 / Number 3
Original
Post-ERCP pancreatitis: early precut or pancreatic duct stent? A multicenter, randomized-controlled trial and cost-effectiveness analysis

174-179

DOI: 10.17235/reed.2017.4565/2016

Hui Jer Hwang, Martín Alejandro Guidi, Cecilia Curvale, Juan Lasa, Raúl Matano,

Abstract
ABSTRACT Background: Pancreatitis is the most frequent complication due to ERCP. Pancreatic duct stent placement has been described as a preventive measure. There is also evidence pointing towards the preventive effect that early precut may provide. Aim: To determine and compare the cost-effectiveness of an early precut approach versus pancreatic duct stent placement for the prevention of post-ERCP pancreatitis. Methods: This was a multicenter, randomized-controlled pilot study with a cost-effectiveness analysis performed between early precut (group A) and pancreatic duct stent (group B) for the prevention of pancreatitis in high-risk patients. Patients with a difficult biliary cannulation and at least one other risk factor for post-ERCP pancreatitis were enrolled and randomized to one of the treatment arms. Both effectiveness and costs of the procedures and their complications were analyzed and compared. Results: From November 2011 to November 2013, 101 patients were enrolled; 50 subjects were assigned to group A and 51 to group B. There were no significant differences in terms of baseline characteristics of patients between groups. Two cases of mild pancreatitis were observed in each group. The overall costs were U$ 1,242.6 per patient in group A and U$ 1,606.5 per patient in group B. The cost in group B was 29.3% higher (p < 0.0001). Conclusion: Early precut showed a better cost-effectiveness profile when compared to pancreatic duct stent placement.
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Hwang H, Guidi M, Curvale C, Lasa J, Matano R. Post-ERCP pancreatitis: early precut or pancreatic duct stent? A multicenter, randomized-controlled trial and cost-effectiveness analysis. 4565/2016


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Publication history

Received: 01/08/2016

Accepted: 22/12/2016

Online First: 10/02/2017

Published: 28/02/2017

Article revision time: 118 days

Article Online First time: 193 days

Article editing time: 211 days


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