Mustafa Shah, MD1, Mohamad A. Meybodi, MD1, Bradley D. Confer, DO1, Dema Shamoon, MD1, Danial H. Shaikh, MD1, David L.. Diehl, MD1, Harshit S. Khara, MD2 1Geisinger Health System, Danville, PA; 2Geisinger Health System, Danville, NJ Introduction: Post-ERCP pancreatitis (PEP) is one of the most common adverse events of ERCP. Prophylactic pancreatic duct (PD) stenting can decrease the incidence of PEP but may require a repeat ERCP for stent removal if there is no spontaneous passage of the stent. Limited evidence exists on the impact of stent size on the likelihood of spontaneous stent passage. Our study aimed to evaluate and compare the rate of spontaneous passage of PD stents of varying sizes. Methods: This retrospective study included all patients who underwent ERCP between January 2014 and January 2024 at Geisinger Health System, a large tertiary center. Stents 4 cm or shorter were categorized as short stents, while stents 5 cm or longer were classified as long stents. The primary outcome was to compare the rate of spontaneous passage between short and long prophylactic PD stents. Secondary outcomes included identifying factors associated with spontaneous passage. Results: A total of 920 patients who underwent ERCP with PD stent placement were identified, of whom 149 (16.2%) had follow-up abdominal X-rays to assess stent passage. Among these 149 patients, 55% were female, 96% were White, and the mean age was 58.7 years. Spontaneous stent passage was seen in 115 (77.2%), while 34 (22.8%) stents were retained. The spontaneous stent passage rate was similar for both long stents and short stents (78.7% vs 66.7%; p = 0.18). In addition, there was no significant difference in subgroup analysis adjusted for stent diameter. However, the smaller diameter 4 Fr stents had a significantly higher rate of spontaneous passage compared to 5 Fr stents [85 (82.5%) vs 30 (65.2%); p = 0.02]. Discussion: Our study demonstrates that smaller 4 Fr diameter stents have better rates of spontaneous stent passage; however, the stent length does not affect passage rates.
Figure: Table 1. Baseline characteristics
Figure: Table 2. Outcomes of prophylactic pancreatic duct stent passage
Disclosures: Mustafa Shah indicated no relevant financial relationships. Mohamad Meybodi indicated no relevant financial relationships. Bradley Confer indicated no relevant financial relationships. Dema Shamoon indicated no relevant financial relationships. Danial Shaikh indicated no relevant financial relationships. David Diehl indicated no relevant financial relationships. Harshit Khara indicated no relevant financial relationships.
Mustafa Shah, MD1, Mohamad A. Meybodi, MD1, Bradley D. Confer, DO1, Dema Shamoon, MD1, Danial H. Shaikh, MD1, David L.. Diehl, MD1, Harshit S. Khara, MD2. P2157 - Predictors of Spontaneous Prophylactic Pancreatic Duct Stent Passage: The Role of Stent Size and Length, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
