Risk Factors for Post-ERCP Pancreatitis in Patients Pretreated with Nafamostat Mesilate.
- Author:
Il Doo KIM
1
;
Dae Hwan KANG
;
Jin Hyun PARK
;
Jung Ho BAE
;
Pyo Jun KIM
;
Yong Wook KIM
;
Cheol Woong CHOI
;
Jae Sup EUM
;
Sun Mi LEE
;
Tae Oh KIM
;
Gwang Ha KIM
;
Geun Am SONG
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. sulsulpul@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Post-ERCP pancreatitis;
Risk factors;
Prevention;
Nafamostat mesilate
- MeSH:
Catheterization;
Cholangiopancreatography, Endoscopic Retrograde;
Common Bile Duct;
Guanidines;
Humans;
Hyperamylasemia;
Mesylates;
Multivariate Analysis;
Pancreatic Ducts;
Pancreatitis;
Prospective Studies;
Protease Inhibitors;
Risk Factors
- From:Korean Journal of Gastrointestinal Endoscopy
2008;37(4):265-270
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGOUND/AIMS: Pancreatitis is the most common and important complication of an endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify risk factors for post ERCP-pancreatitis in patients pretreated with nafamostat mesilate, a synthetic protease inhibitor. METHODS: A total of 247 patients who underwent an ERCP were evaluated prospectively. Potential risk factors of post-ERCP pancreatitis in patients pretreated with nafamostat mesilate were evaluated. RESULTS: Twenty-four patients (9.7%) and nine patients (3.6%) developed post-ERCP hyperamylasemia and pancreatitis, respectively. As determined by univariate analysis among the potential risk factors, we found a procedure time over 20 minutes, pancreatic duct cannulation over four times, prior post-ERCP pancreatitis and the absence of a common bile duct (CBD) stone as risk factors for post-ERCP hyperamylasemia. We also found a patient age under 60 years, a procedure time over 20 minutes, pancreatic duct cannulation over four times and the absence of a CBD stone as risk factors for post-ERCP pancreatitis (p<0.05). As determined by multivariate analysis, pancreatic cannulation over four times is independently associated with post-ERCP hyperamylasemia (p=0.038; OR, 5.165; 95% CI, 1.093~24.412) and post-ERCP pancreatitis (p=0.002; OR, 33.122; 95% CI, 3.526~311.138). CONCLUSIONS: A repeated pancreatic duct cannulation is the most important risk factor for post-ERCP pancreatitis in patients pretreated with nafamostat mesilate.
