Should we abandon the use of prophylactic PD stents to prevent post-ERCP pancreatitis?

To the Editor: Sotoudehmanesh et al. (1) report an interesting randomized controlled trial showing a reduction in the incidence of post-ERCP pancreatitis (PEP) when sublingual nitroglycerine was given along with rectal indomethacin 30 min before ERCP compared with giving indomethacin alone. An absolute risk reduction of 8.6% and a number needed to treat of 12 patients were reported. Pancreatic duct (PD) stents were placed only in 5.7% or 17 patients (8 in the combined group, and 7 in the indomethacin alone group). These results seem promising in the world of PEP prevention and may even question the role of placing PD stents. So, should we abandon the use of PD stents?