Risk factors for moderate to severe pancreatitis after endoscopic retrograde cholangiopancreatography
10.3760/cma.j.cn321463-20211111-00609
- VernacularTitle:经内镜逆行胰胆管造影术后中重度胰腺炎的危险因素分析
- Author:
Yan ZHANG
1
;
Gui REN
;
Xin SHI
;
Jingyi WANG
;
Xu WANG
;
Lijun LOU
;
Long CHEN
;
Yanglin PAN
Author Information
1. 空军军医大学第一附属医院消化内科，西安710032
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Pancreatitis;
Risk factors;
Moderate-to-severe pancreatitis
- From:
Chinese Journal of Digestive Endoscopy
2022;39(10):807-812
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for moderate to severe pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP) .Methods:Data of 6 731 patients diagnosed as having biliary and pancreatic diseases with initial papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) from June 2010 to June 2020 in the First Affiliated Hospital of Air Force Medical University were retrospectively analyzed. Parameters related to intubation and postoperative complications were prospectively collected. The main end point was moderate to severe PEP. Logistic regression analysis was used to explore the risk factors for moderate to severe PEP.Results:The incidence of overall PEP and moderate to severe PEP in 6 731 ERCP patients with initial papilla were 5.3% ( n=359) and 1.0% ( n=68) respectively. Univariate analysis showed that female, indications of ERCP, cannulation method, cannulation time, cannulation attempts, times of inadvertent pancreatic duct cannulation and cannulation with or without trainee involvement were all associated with moderate to severe PEP ( P<0.10). Multivariate analysis showed that female ( OR=2.32, 95% CI:1.28-4.21, P=0.006), non-common bile duct stones indication ( OR=2.04, 95% CI:1.16-3.59, P=0.014), cannulation time ≥5 min ( OR=2.23, 95% CI: 1.20-4.13, P=0.011), inadvertent pancreatic duct cannulation time ≥1 ( OR=1.88, 95% CI: 1.03-3.44, P=0.040) and non-trainee involvement cannulation ( OR=1.81, 95% CI: 1.02-3.22, P=0.043) were independent risk factors for moderate to severe PEP. Conclusion:The independent risk factors for moderate to severe PEP include female, non-common bile duct stones indication, non-trainee involvement cannulation and difficult cannulation. Great importance should be attached to these factors above during the whole perioperative period of ERCP.
