Aims
To evaluate the feasibility and clinical outcomes of early therapeutic PD stenting in patients with severe PEP.
Methods
From 2020 to 2024, 879 retrograde interventions on the major papilla were performed. Severe PEP occurred in 14 patients, divided into:
- Group 1 (n=7): conservative management;
- Group 2 (n=7): attempted therapeutic PD stenting within 24 hours.
Therapeutic stenting was successful in 5/7 patients. Straight plastic stents 5 Fr × 5 cm without flaps were used.
Results
All successfully stented patients demonstrated:
- significant pain reduction within 48 hours,
- normalization of laboratory parameters within 48–72 hours,
- no development of peripancreatic fluid collections.
In the conservative group, fluid collections developed in 3/7 patients, requiring drainage.No mortality was observed in either group.
Conclusions
Early therapeutic PD stenting appears feasible and clinically beneficial in selected patients with severe PEP, resulting in faster symptom resolution and fewer complications.These findings support the need for prospective controlled studies to clarify indications, timing, and the potential role of therapeutic PD stenting in the management of severe PEP