Application of Pancreatic Duct Stenting in ERCP for Choledocholithiasis

Abstract

Objective: To analyze the application effect of pancreatic duct stenting in patients with common bile duct stones undergoing endoscopic retrograde cholangiopancreatography (ERCP). Methods: Clinical data of 215 patients with common bile duct stones treated in the hospital from January 2020 to December 2024 were retrospectively analyzed. Based on the biliary drainage method, patients were divided into a nasobiliary drainage group (n=110) and a pancreatic duct stent group (n=105). Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), C-reactive protein (CRP), white blood cell (WBC) count, and serum amylase were compared between the two groups before and after the procedure. The incidence of post-ERCP pancreatitis (PEP) and hyperamylasemia, as well as postoperative recovery parameters, were also assessed. Results: Preoperatively, no significant differences were observed between the two groups in ALT, AST, TBIL, WBC, CRP, or serum amylase levels (P>0.05). Postoperatively, levels of ALT, AST, TBIL, WBC, and CRP in both groups were significantly lower than their respective preoperative levels (P<0.05), while serum amylase levels were significantly higher (P<0.05). Furthermore, all these postoperative indicators in the pancreatic duct stent group were significantly lower than those in the nasobiliary drainage group (P<0.05). The incidence of PEP in the pancreatic duct stent group was 5.71% (6/105), which was significantly lower than the 24.55% (27/110) in the nasobiliary drainage group (P<0.05). Postoperative Visual Analog Scale (VAS) pain scores, time to first oral intake, and hospital stay in the pancreatic duct stent group were (3.51±0.69) points, (14.15±3.63) hours, and (5.71±1.03) days, respectively. These values were all significantly lower or shorter than those in the nasobiliary drainage group: (4.55±0.77) points, (24.71±3.97) hours, and (8.15±1.34) days (P<0.05). Conclusion: In patients with common bile duct stones undergoing ERCP, placement of a pancreatic duct stent can ameliorate systemic inflammatory response and improve liver function, reduce the incidence of PEP, and promote postoperative recovery.