November 12, 2014
Notes: Lee, Wei-Sin
China (Republic : 1949- )
Kaohsiung J Med Sci. 2013 Sep;29(9):469-77. doi: 10.1016/j.kjms.2012.10.007. Epub 2013 Jan 12.
Author Address: Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Reference Type: Journal Article
Record Number: 4957Author: Leghari, A., Ghazanfar, S., Qureshi, S., Taj, M. A., Niaz, S. K. and Quraishy, M. S.
Title: Frequency and risk factors in the post-ERCP pancreatitis in a tertiary care centre
Journal: J Coll Physicians Surg Pak
Short Title: Frequency and risk factors in the post-ERCP pancreatitis in a tertiary care centre
Alternate Journal: Journal of the College of Physicians and Surgeons–Pakistan : JCPSP
ISSN: 1681-7168 (Electronic)
Accession Number: 24034184
Keywords: Abdominal Pain/etiology
Cholangiopancreatography, Endoscopic Retrograde/*adverse
Process Assessment (Health Care)
Abstract: OBJECTIVE: To evaluate the frequency and associated factors in the post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Endoscopy Suite of Surgical Unit IV, Civil Hospital, Karachi, from December 2009 to November 2010. METHODOLOGY: Patients undergoing ERCP were included. Patients who had presented with pancreatitis or raised amylase levels before procedure or patients who had previous history of surgery on the biliary or pancreatic systems were excluded from the study. Pearson chi-square and Fisher’s exact test were used for qualitative data and t-test for quantitative data. Significance was taken as p (2) 0.05. Odds ratio was calculated for the qualitative data using 95% confidence interval. RESULTS: Age of the study population ranged from 9 to 90 years (mean age 46.5 +/- 14.94 years, median 45 years). Male to female ratio was 1:1.87. Pancreatitis was seen in 18 patients (3.6%), mild in 15 (3%), moderate in one (0.2%) and severe in 2 (0.4%). Mean amylase level at 4 hours and 24 hours was 280.93 +/- 539.13 and 168.83 +/- 338.34 respectively. Pancreatitis was seen in 15/326 (4.6%) females and 3/174 (1.72%) males. Statistically significant increased risk for pancreatitis was seen in difficult cannulation (9.8%, p = 0.006), prolonged cannulation time (7.6 minute, p = 0.002), pancreatic duct cannulation (13.7%, p = 0.001) and pancreatic duct contrast injection (13.4%, p < 0.001). CONCLUSION: The frequency of post-ERCP pancreatitis was 3.6%. Difficult cannulation, pancreatic duct cannulation, pancreatic duct contrast injection and balloon sphincteroplasty were associated with higher frequency of post-ERCP pancreatitis. Reuse of ERCP accessories poses no additional risk to the frequency of pancreatitis.