**10.2 Pancreatic duct stents**

In a meta-analysis evaluating 4 randomized prospective trials by Andriulli et al. [45] pancreatic duct stent placement had a twofold reduction in the incidence of post-ERCP pancreatitis (24.1% vs. 12%; P = 0.009; odds ratio: 0.44, 95% confidence interval: 0.24–0.81). Pancreatic duct stent insertion is technically difficult and there is need for follow-up evalutation to ensure passage or removal and associated with potential pancreatic ductal injuries. Insertion failure rates ranging from 4 to 10% have been reported and a higher incidence of severe pancreatitis among patients with failed pancreatic duct stenting [45–47].
