Use of biodegradable stents in ERCP: lessons from a single high-volume centre

Objectives The Archimedes biodegradable stents (ABSs) are licensed for use in endoscopic retrograde cholangiopancreatography (ERCP). The objectives of this study were to evaluate the clinical use in both biliary and pancreatic indications in paediatric and adult populations. Methods This was a retrospective study of an unselected population of 132 patients who received an ABS during an ERCP over a 53-month period. Data collected included baseline characteristics, indications for ERCP and success of ABS placement. Postprocedural adverse events were also collected. Results 138 ABSs were inserted into 132 patients of which 20 patients were paediatrics (60% male, median age 11.8 years). 96 pancreatic ABSs were placed (n=89 fast degradation). Fast degradation stents were used prophylactically to mitigate against pancreatitis or for a strictured pancreatic duct (PD). 42 biliary Archimedes stents were placed (n=40 slow degradation stents). Slow degradation stents were placed following stone fragmentation and for those awaiting surgical intervention. Overall, 63.6% of patients (n=84) required a pancreatic ABS to mitigate against pancreatitis as the PD was initially cannulated or contrast was injected—only 3.0% developed post-ERCP pancreatitis. 97% of ABSs were placed successfully. There were no reported adverse events relating to the use of ABS. Conclusion The ABS is safe and highly efficacious in the use of both pancreatic and biliary indications at ERCP in adult and paediatric populations. Further indications for the use of the ABS appear to be evolving in clinical practice.