Qi Bin He1, Te Xu2, Jing Wang3, Yun Hong Li1, Lei Wang1, Xiao Ping Zou1. 1. Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. 2. Department of Vasculocardiology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. 3. Department of Infectious Disease, The First People's Hospital of Changzhou, Changzhou, China.
Abstract
OBJECTIVE: With an increased use of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP complications have attracted much attention. We aimed to identify independent risk factors of post-ERCP pancreatitis (PEP) and hyperamylasemia, and to develop a simple scoring system of the factors contributing to the clinical prevention against PEP. METHODS: A retrospective single-center analysis was performed in 4234 ERCP procedures between September 2007 and December 2012. Patient-related and procedure-related risk factors for PEP and post-ERCP hyperamylasemia were identified by univariate and multivariate regression analyses. A scoring system was developed based on the independent risk factors. RESULTS: PEP occurred in 226 (5.3%) ERCP procedures and hyperamylasemia in 774 (18.3%) procedures. Female gender (odds ratio [OR] 1.449), first-time ERCP (OR 1.745), latent jaundice (OR 1.917), difficult cannulation (OR 3.317) and pancreatography (OR 1.823) were all proven to be significant risk factors for predicting PEP. In addition, difficult cannulation (OR 1.990) and pancreatography (OR 2.009), age <60 years (OR 1.294), prior diabetes (OR 0.614), biliary duct stent placement (OR 1.884) and nasobiliary drainage (OR 1.613) were associated with developing hyperamylasemia. Prophylactic pancreatic duct stent (PS) might prevent against PEP in significantly high-risk patients (score ≥6). CONCLUSIONS: Both patient-related and procedure-related risk factors are important for predicting PEP and post-ERCP hyperamylasemia. Technical procedures, for example, PS, are necessary to prevent PEP in patients at the highest risk.
OBJECTIVE: With an increased use of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP complications have attracted much attention. We aimed to identify independent risk factors of post-ERCP pancreatitis (PEP) and hyperamylasemia, and to develop a simple scoring system of the factors contributing to the clinical prevention against PEP. METHODS: A retrospective single-center analysis was performed in 4234 ERCP procedures between September 2007 and December 2012. Patient-related and procedure-related risk factors for PEP and post-ERCP hyperamylasemia were identified by univariate and multivariate regression analyses. A scoring system was developed based on the independent risk factors. RESULTS: PEP occurred in 226 (5.3%) ERCP procedures and hyperamylasemia in 774 (18.3%) procedures. Female gender (odds ratio [OR] 1.449), first-time ERCP (OR 1.745), latent jaundice (OR 1.917), difficult cannulation (OR 3.317) and pancreatography (OR 1.823) were all proven to be significant risk factors for predicting PEP. In addition, difficult cannulation (OR 1.990) and pancreatography (OR 2.009), age <60 years (OR 1.294), prior diabetes (OR 0.614), biliary duct stent placement (OR 1.884) and nasobiliary drainage (OR 1.613) were associated with developing hyperamylasemia. Prophylactic pancreatic duct stent (PS) might prevent against PEP in significantly high-risk patients (score ≥6). CONCLUSIONS: Both patient-related and procedure-related risk factors are important for predicting PEP and post-ERCP hyperamylasemia. Technical procedures, for example, PS, are necessary to prevent PEP in patients at the highest risk.
Authors: Ayman El Nakeeb; Ehab El Hanafy; Tarek Salah; Ehab Atef; Hosam Hamed; Ahmad M Sultan; Emad Hamdy; Mohamed Said; Ahmed A El Geidie; Tharwat Kandil; Mohamed El Shobari; Gamal El Ebidy Journal: World J Gastrointest Endosc Date: 2016-11-16
Authors: Adriana Fabiola Romano-Munive; J Jesus García-Correa; Luis F García-Contreras; José Ramírez-García; Luis Uscanga; Varenka J Barbero-Becerra; Carlos Moctezuma-Velázquez; Jorge A Ochoa-Rubí; Julio Toledo-Cuque; Gerardo Vázquez-Anaya; Daniel Keil-Ríos; Guido Grajales-Figueroa; Miguel Ángel Ramírez-Luna; Francisco Valdovinos-Andraca; Luis Eduardo Zamora-Nava; Felix Tellez-Avila Journal: BMJ Open Gastroenterol Date: 2021-02