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- W4251288622 abstract "We thank Drs. Adler and Baron for their interest in our study. We agree that after reading our article,1Coté G.A. Kumar N. Ansstas M. et al.Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents.Gastrointest Endosc. 2010; 72: 748-754Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar endoscopists should not consider withholding the use of a metal stent in their current practice. As we explicitly acknowledge in our conclusion, metal biliary stents “remain the preferred device because of their superior patency rates” for patients with biliary obstruction secondary to unresectable malignancy. On the other hand, our observations should not be considered inconclusive because our study represents the largest patient population undergoing biliary metal stent placement, we controlled for known risk factors of post-ERCP pancreatitis (PEP), and our reported rates of PEP are in agreement with those of several other published studies. Our findings raise 2 important issues: first, are patients with abdominal pain and elevated pancreatic enzymes after placement of a metal stent having pancreatitis or symptoms related to stent expansion with associated post-ERCP pancreatic enzyme elevation? Stated alternatively, should we reconsider our definition of PEP for this particular cohort? Second, the potential risk of metal stent–associated PEP is an important consideration as we consider their use for currently unapproved indications: fully covered metal stents as a potential first-line therapy for benign biliary strictures and in cases of malignant, resectable biliary obstruction. PEP will be an important safety measure in any trial evaluating metal stents for benign indications. The risk profile of metal stents will continue to evolve as we push the limits of their use in ERCP. Biliary self-expandable metal stents and the risk of post-ERCP pancreatitis: the jury is still outGastrointestinal EndoscopyVol. 73Issue 5PreviewWe read with interest the article by Coté et al1 regarding the risk of post-ERCP pancreatitis (PEP) after placement of biliary self-expandable metal stents (SEMSs). This has been a topic of considerable interest to us for several years, given the increasing frequency with which biliary SEMSs are used for palliation of biliary obstruction, most commonly because of cancer. The article, and its accompanying editorial, might lead readers to consider withholding the placement of a biliary SEMS out of fear of causing PEP. Full-Text PDF" @default.
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- W4251288622 date "2011-05-01" @default.
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- W4251288622 title "Response" @default.
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- W4251288622 doi "https://doi.org/10.1016/j.gie.2010.12.007" @default.
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