Pancreatic duct stenting in the early phase of acute necrotizing pancreatitis: a retrospective study

The efficacy and safety of pancreatic duct (PD) stenting in the early phase of acute necrotizing pancreatitis (ANP) remains controversial. This study aims to explore the efficacy and safety of PD stenting in the early phase of ANP. A retrospective cohort study was conducted, encompassing the collection of clinical data from 131 ANP patients admitted to Ningxia Medical University General Hospital between 1 June 2019, and 30 December 2022. The patients were divided into two groups based on different treatment methods: stent group ( n = 70) and control group ( n = 61). Prognostic indicators of both groups were analyzed. The stent group demonstrated a significant reduction in primary endpoints compared to the control group ( P < 0.05). Subsequent analysis revealed significant reductions in specific parameters within the composite outcome, including new-onset organ failure, new-onset respiratory failure, new-onset single organ failure, new-onset systemic complications, sepsis, and abdominal hypertension in the stent group compared to the control group ( P < 0.05). Pancreatic leakage occurred in 5 (8.2%) patients in the control group, while the stent group showed complete recovery without incidents of pancreatic leakage, indicating significant differences between the two groups ( P < 0.05). The stent group also exhibited shorter oral refeeding, fewer analgesic doses, and shorter hospital stay. Moreover, the APACHE II score within 48 h of admission was lower in the stent group, with statistically significant variances ( P < 0.05). Multivariate analysis identified grouping [OR (95% CI) 0.208 (0.080–0.545)], CT severity index [OR (95%CI) 1.373 (1.102–1.710)], and organ failure upon admission [OR (95%CI) 7.428 (1.763–31.300)] as independent risk factors for primary endpoints. PD stenting in the early phase of ANP is associated with a reduced incidence of new-onset systemic complications, organ failure, and pancreatic fistula, indicating its potential in mitigating disease progression. PD stenting also correlates with symptom relief, shorter oral refeeding time, and reduced hospital stay, potentially aiding recovery. In cases of poor drainage efficacy or secondary infections causing discomfort, combined treatment with percutaneous drainage (PCD) may be considered due to its demonstrated therapeutic effectiveness. Trial Registration : This study was recorded as a single-center, retrospective case–control study (ChiCTR1900025833), 2019/06.