Analysis of risk factors for post-ERCP pancreatitis
10.3760/cma.j.issn.1007-5232.2014.09.006
- VernacularTitle:经内镜逆行胰胆管造影术后并发胰腺炎的危险因素分析
- Author:
Te XU
;
Jing WANG
;
Yunhong LI
;
Yuling YAO
;
Qibin HE
;
Jun CAO
;
Han WU
;
Xiaoping ZOU
- Publication Type:Journal Article
- Keywords:
Cholangiopancreatography,endoscopic retrograde;
Pancreatitis;
Risk factor;
Uni-variate analysis;
Independent risk factor
- From:
Chinese Journal of Digestive Endoscopy
2014;(9):503-507
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of post-ERCP pancreatitis( PEP). Methods Data of 4,234 patients who underwent ERCP in Nanjing Drum Tower Hospital were retrospectively analysed. Information of patients and operations,including age,gender,operation history,major disease history,labora-tory examination before operation,abdominal ultrasound,CT,MRCP,detailed ERCP operation process,com-plications and treatment were carefully recorded. Then Chi-square test was used for univariate analysis,and stepwise multivariate Logistic regression for variate analysis. Linear correlations between risk factors were de-tected. Results There were totally 226 PEPs,with 5. 3% incidence rate. Univariate analysis showed that the female(χ2 =9. 715,P=0. 002),young( <60 years)(χ2 =6. 108,P=0. 013),chronic pancreatitis(χ2 =14. 703,P=0. 001),initial ERCP(χ2 =14. 899,P=0. 000),hypertension(χ2 =4. 489,P=0. 034),nor-mal bilirubin levels before operation(χ2 =19. 159,P =0. 000 ),difficult cannulation(χ2 =45. 824,P =0. 000),pancreatic guide wire(χ2 =30. 223,P=0. 000),papillary pre cut(χ2 =45. 928,P=0. 000),pan-creatography(χ2 =20. 170,P=0. 000)may be risk factors for PEP. Non conditional Logistic regression analy-sis showed that female(OR=1. 449,P=0. 011),initial ERCP(OR=1. 745,P=0. 003),normal bilirubin levels before operation(OR=1. 917,P=0. 000),difficult cannulation(OR=3. 317,P=0. 000)and pancre-atography(OR=1. 823,P=0. 004)were independent risk factors for PEP. Linear correlation analysis sugges-ted that pancreatic duct guide wire and papillary precut were related to the difficult cannulation,and the corre-lation coefficients were -0. 788 and -0. 699. Conclusion Female,young(<60 years),chronic pancreati-tis,initial ERCP,hypertension,normal bilirubin levels,difficult cannulation,pancreatic duct guide wire,pa-pillary precut,pancreatography may induce PEP. Female,normal bilirubin levels before operation,initial ER-CP,difficult cannulation and pancreatography are independent risk factors for PEP,while pancreatic duct guide wire,papillary precut are not,as they were linear correlated to difficult cannulation.
