Risk Factors of Pancreatitis after Endoscopic Retrograde Cholangiopancreatography

Shahryar Hashemzadeh, Mohammad Hossein Somi, Touraj Asvadi, Afshin Habibzadeh, Farzad Kakaei

Abstract


Introduction: Pancreatitis is the common complication of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Diagnosing the risk factors for post-ERCP pancreatitis is important in the management of patients. In this study, we evaluated possible risk factors of post-ERCP pancreatitis among Iranian patients.

Materials and methods: In this retrospective study, 708 diagnostic and therapeutic ERCPs performed in Imam Reza hospital, Tabriz, Iran between April 2011 and September 2012 were studied. The rate of post-ERCP pancreatitis and possible risk factors were evaluated using a multivariate regression analysis.

Results: Post-ERCP pancreatitis occurred in 4.58% of cases. Unsuccessful ERCP (27% vs. 12.4%, p=0.02) and Body mass index (23.48±3.02 vs. 26.11±4.70 kg/m2, p=0.002) were significantly higher in patients with pancreatitis compared to those without pancreatitis. Regression analysis showed that only lower body mass index was the independent risk factor for post-ERCP pancreatitis occurrence (OR=1.341, CI95%[1.003-1.793], p=0.04).

Conclusion: Among identifiable risk factors, only lower body mass index was the independent predictor of post-ERCP pancreatitis.

 

Keywords: Endoscopic retrograde cholangiopancreatography; Pancreatitis; Risk factor


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References


Baron TH, Petersen BT, Mergener K, Chak A, Cohen J, Deal SE, et al. Quality indicators for endoscopic retrograde cholangiopancreatography. Gastrointest Endosc. 2006;101:892–97.

Mohammad Alizadeh AH, Afzali ES, Mousavi M, Moaddab Y, Zali MR. Endoscopic retrograde cholangiopancreatography outcome from a single referral center in Iran. Hepatobiliary Pancreat Dis Int. 2010;9:428-32.

Cotton PB, Garrow DA, Gallagher J, Romagnuolo J. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc. 2009;70:80-88.

Glomsaker T, Hoff G, Kvaløy JT, Søreide K, Aabakken L, Søreide JA. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. Br J Surg. 2013;100:373-380.

Cheon YK, Cho KB, Watkins JL, McHenry L, Fogel EL, Sherman S, et al. Frequency and severity of post-ERCP pancreatitis correlated with extent of pancreatic ductal opacification. Gastrointest Endosc. 2007;65:385-393.

Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335:909-918.

Testoni PA, Mariani A, Giussani A, Vailati C, Masci E, Macarri G, et al. Risk factors for post-ERCP pancreatitis in high- and low volume centers and among expert and non-expert operators: a prospective multicenter study. Am J Gastroenterol. 2010;105:1753-1761.

Cheng CL, Sherman S, Watkins JL, Barnett J, Freeman M, Geenen J, et al. Risk factors for post-ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol. 2006;101:139-147.

Hashemzadeh S, Somi MH, Pourzand A, Asvadi T, Habibzadeh A, Kakaei F. Surgical and non-surgical management of endoscopic retrograde cholangiopancreatography complications. J Clin Anal Med. 2013; DOI: 10.4328/JCAM.2114.

Murray WR. Reducing the incidence and severity of post ERCP pancreatitis. Scand J Surg. 2005;94:112-116.

Fazel A, Quadri A, Catalano MF, Meyerson SM, Geenen JE. Does a pancreatic duct stent prevent post-ERCP pancreatitis? A prospective randomized study. Gastrointest Endosc. 2003;57:291-294.

Vitte RL, Morfoisse JJ. Evaluation of endoscopic retrograde cholangiopancreatography procedures performed in general hospitals in France. Gastroenterol Clin Biol. 2007;31:740-749.

Freeman ML, DiSario JA, Nelson DB, Fennerty MB, Lee JG, Bjorkman DJ, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001;54:425–34.

Wang P, Li ZS, Liu F, Ren X, Lu NH, Fan ZN, et al. Risk factors for ERCP-related complications: a prospective multicenter study. Am J Gastroenterol. 2009;104:31–40.

Masci E, Mariani A, Curioni S, Testoni PA. Risk factors for pancreatitis following endoscopic retrograde cholangio-pancreatography: a meta-analysis. Endoscopy. 2003;35:830–4.

Li N, Tieng A, Novak S, Fernandes A, Jalal PK, Akerman M, et al. Effects of medications on postendoscopic retrograde cholangiopancreatography pancreatitis. Pancreatology. 2010;10:238-242.

DiMagno MJ, Spaete JP, Ballard DD, Wamsteker EJ, Saini SD. Risk models for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP): smoking and chronic liver disease are predictors of protection against PEP. Pancreas. 2013;42:996-1003.

Döbrönte Z, Toldy E, Márk L, Sarang K, Lakner L. Effects of rectal indomethacin in the prevention of post-ERCP acute pancreatitis. [Article in Hungarian] Orv Hetil. 2012;153(25):990-6.

Xu LH, Qian JB, Gu LG, Qiu JW, Ge ZM, Lu F, et al. Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by epinephrine sprayed on the papilla. J Gastroenterol Hepatol. 2011;26(7):1139-44.

Deenadayalu VP, Blaut U, Watkins JL, Barnett J, Freeman M, Geenen J, et al. Does obesity confer an increased risk and/or more severe course of post-ERCP pancreatitis?: a retrospective, multicenter study. J Clin Gastroenterol. 2008;42(10):1103-9.


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