Evidence map›Paper›PMID 41954674›Full record

SynthesisDigestive diseases and sciences2026

Pancreatic Duct Stenting During ERCP in Patients with Acute Biliary Pancreatitis: A Systematic Review and Meta-analysis.

Ahmed Elmoursi, Khaled Elfert, Azizullah Beran, Vishali Moond, Sherif E Elhanafi, Shailendra Singh, Matthew Krafft, Shyam Thakkar

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Ahmed ElmoursiDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Khaled ElfertDivision of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA. Kh.elfert90@gmail.com.
Azizullah BeranDivision of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA.
Vishali MoondDivision of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
Sherif E ElhanafiDivision of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, 79905, USA.
Shailendra SinghDivision of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
Matthew KrafftDivision of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.
Shyam ThakkarDivision of Gastroenterology and Hepatology, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26506, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with acute biliary pancreatitis (ABP), endoscopic retrograde cholangiopancreatography (ERCP) is generally recommended in the setting of suspected biliary obstruction or concomitant cholangitis. Prophylactic pancreatic duct (PD) stenting has been shown to lower the risk of post-ERCP pancreatitis in high-risk patients, yet its effect on the course of ABP specifically is not well understood. In this context, the present study aims to determine whether PD stenting during ERCP can reduce the likelihood of worsening pancreatitis in patients with ABP who undergo ERCP.

objectiveTo evaluate the impact of prophylactic PD stenting on clinical outcomes in patients with ABP undergoing ERCP, focusing on post-ERCP complications and hospital-related outcomes including length of stay (LOS) and mortality.

methodsA systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, Cochrane Library, and CINAHL were searched for studies published between January 2010 and June 2025. Eligible studies compared outcomes between PS and no-stent groups in adult ABP patients undergoing ERCP. Data were synthesized using a random-effects model in Review Manager (RevMan) 5.4.1. Risk of bias was assessed using ROBINS-I.

resultsFive studies comprising 727 patients were included. PS significantly reduced post-ERCP complications compared to controls (RR 0.45; 95% CI 0.22-0.89; p = 0.02). PS was associated with a significant reduction in pancreatic fluid collections (RR 0.29; 95% CI 0.12-0.74; p = 0.009). PS was also associated with reduced hospital LOS (SMD - 1.10; 95% CI - 2.15 to - 0.06; p = 0.04). The incidences of systemic inflammatory response syndrome (SIRS), new-onset organ failure (OF) (RR 0.57; 95% CI 0.22-1.48; p = 0.25; I2 = 0%), and mortality (RR 0.31; 95% CI 0.08-1.16; p = 0.08; I2 = 0%) were all lower in the stent group compared with controls, although these differences did not reach statistical significance. Risk of bias varied across studies, with most demonstrating a mild-to-moderate overall risk. Risk of bias was generally low across studies, with one study demonstrating moderate risk.

conclusionsProphylactic pancreatic duct stenting is associated with a significant reduction in post-ERCP complications, lower rates of pancreatic fluid collections, and shorter hospitalization in patients with acute biliary pancreatitis undergoing ERCP. These findings support selective use of PS during inadvertent PD cannulation in high-risk ABP populations. Future large-scale, multicenter prospective trials are required to optimize stent characteristics, validate patient selection criteria, and evaluate long-term outcomes.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradePancreatic DuctsPancreatitisStentsAcute DiseaseHumansLength of StayTreatment OutcomeAcute biliary pancreatitisEndoscopic interventionEndoscopic retrograde cholangiopancreatography (ERCP)Gallstone pancreatitisMeta-analysisOrgan failurePancreatic duct stentingPancreatic fluid collectionsPost-ERCP pancreatitisProphylactic stentingSystematic review

Identifiers

PMID41954674

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.