Covered metal biliary stents and risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis

This is a multicenter retrospective cohort study involving tertiary referral centers in Australia. Consecutive adult patients who underwent ERCP for biliary indications between October 2016 and October 2019 were included in the study. Primary pancreatic indications (such as pancreatic duct strictures or stones) and procedures aborted prior to attempted cannulation were excluded. Procedural decisions including endoscopic biliary sphincterotomy, stent choice and use of post-ERCP pancreatitis prophylaxis were at the discretion of the treating endoscopist. Data was collected by electronic chart review only, with no participant involvement required. Clinical characteristics, procedural information, and any post-procedural adverse events were collected from electronic chart review at each center. The primary endpoint was rate of post-ERCP pancreatitis (within 30 days post-procedure). Secondary endpoints included severity of pancreatitis, other procedure-related adverse events (bleeding, perforation, cholangitis; occurring within 30 days post-procedure) and stent-related adverse events occurring within 90 days post-procedure (stent migration or stent occlusion).