Does Obesity Confer an Increased Risk and/or More Severe Course of Post-ERCP Pancreatitis?

Deenadayalu, Viju P.; Błaut, U; Watkins, James L.; Barnett, Jeffrey L.; Freeman, Martin L.; Geenen, Joseph E.; Ryan, Michael E.; Parker, Harrison W.; Frakes, James T.; Fogel, Evan L.; Silverman, William B.; Dua, Kulwinder S.; Aliperti, Giuseppe; Yakshe, Paul N.; Uzer, Michael; Jones, Warren T.; Goff, John S.; Temkit, MʼHamed; Lehman, Glen A.; Sherman, Stuart

doi:10.1097/mcg.0b013e318159cbd1

Cited by 27 publications

(16 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several factors may explain these variations as the inclusion and exclusion criteria were different and the proportion of patients with obesity was not specified. Therefore, interpreting and comparing the results is difficult considering the heterogeneity of patient populations, methods, and outcome reporting among all the various publications [11]. …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Obesity and Decompressive Laparotomy on Mortality in Acute Pancreatitis Requiring Intensive Care Unit Admission

et al. 2012

View full text Add to dashboard Cite

BackgroundControversy still exists on the effect that obesity has on the morbidity and mortality in severe acute pancreatitis (SAP). The primary purpose of this study was to compare the mortality rate of obese versus nonobese patients admitted to the ICU for SAP. Secondary goals were to assess the potential risk factors for abdominal compartment syndrome (ACS) and to investigate the performance of validated scoring systems to predict ACS and in-hospital mortality.MethodsA retrospective cohort of adults admitted to the ICU for SAP was stratified by their body mass index (BMI) as obese and nonobese. The rates of morbidity, mortality, and ACS were compared by univariate and multivariate regression analyses. Areas under the curve (AUC) were used to evaluate the discriminating performance of severity scores and other selected variables to predict mortality and the risk of ACS.ResultForty-five patients satisfied the inclusion criteria and 24 (53 %) were obese with similar characteristics to nonobese patients. Among all the subjects, 11 (24 %) died and 16 (35 %) developed ACS. In-hospital mortality was significantly lower for obese patients (12.5 vs. 38 %; P = 0.046) even though they seemed to develop ACS more frequently (41 vs. 28 %; P = 0.533). At multivariable analysis, age was the most significant factor associated with in-hospital mortality (odds ratio (OR) = 1.273; 95 % confidence interval (CI) 1.052–1.541; P = 0.013) and APACHE II and Glasgow-Imrie for the development of ACS (OR = 1.143; 95 % CI 1.012–1.292; P = 0.032 and OR = 1.221; 95 % CI 1.000–1.493; P = 0.05) respectively. Good discrimination for in-hospital mortality was observed for patients’ age (AUC = 0.846) and number of comorbidities (AUC = 0.801). ACS was not adequately predicted by any of the clinical severity scores (AUC = 0.548–0.661).ConclusionsPatients’ age was the most significant factor associated with mortality in patients affected by SAP. Higher APACHE II and Glasgow-Imrie scores were associated with the development of ACS, but their discrimination performance was unsatisfactory.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Body mass index (BMI; Kg/m 2 ) ≥30 was used as a cutoff point to identify obese patients according to the definition proposed by the World Health Organization [11]. …”

Section: Definitionsmentioning

confidence: 99%

Effect of Obesity and Decompressive Laparotomy on Mortality in Acute Pancreatitis Requiring Intensive Care Unit Admission

et al. 2012

View full text Add to dashboard Cite

show abstract

“…It is not completely clear from our data what role obesity and/or insulin resistance might play in predisposition to ERCP-related sepsis, though the ERD group did have a high average BMI, and half of ERD patients had diabetes, including 4 of the 5 who had sepsis as a fatal complication. Other studies looking at obesity as a risk factor for ERCP complications have not shown a clear risk [9].…”

Section: Discussionmentioning

confidence: 95%

Death after endoscopic retrograde cholangiopancreatography: findings at autopsy

et al. 2010

View full text Add to dashboard Cite

“…Other studies have not identified obesity as an independent risk factor. [16,17] Some studies have linked laboratory findings in diagnosing acute pancreatitis. The pancreas is the primary source of serum lipase.…”

Section: Discussionmentioning

confidence: 99%

Post-ERCP pancreatitis and its related factors: A prospective study in Cipto Mangunkusumo National General Hospital

Makmun

Abdullah

Syam

et al. 2015

Journal of Digestive Endoscopy

View full text Add to dashboard Cite

Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is a widely used procedure for the diagnosis and treatment of pancreatobiliary disease with post-ERCP pancreatitis (PEP) is the most common complication. The goal of this study was to comprehensively evaluate the potential patient- and procedure-related risk factors for PEP. Methods: A 25-variable database was compiled from information collected before, during, and 24-72 h after ERCP for 238 patients who underwent diagnostic or therapeutic ERCP in Cipto Mangunkusumo General National Hospital, Jakarta. The grading of acute pancreatitis was classified using the modified Glasgow (Imrie′s) severity criteria. Results: The average age was 51 years, and most patients were men and were overweight. Sixty-three patients (26.5%) were diagnosed with PEP, and 33 of these (52.4%) were classified as having severe pancreatitis. We applied univariate analysis to analyze the data contained in the 25-variable database to identify patient- and procedure-related predictors of PEP. We found significant correlations between PEP and the patient-related factor common bile duct stenosis (P < 0.05), and between PEP and the three procedure-related factors procedure time, cannulation time, and multiple cannulation attempts (P < 0.05). Multivariate analysis showed that multiple attempts at cannulations was the only significant risk factor for PEP. Conclusions: In our study, four variables were associated with PEP: Common bile duct stenosis, procedure time, cannulation time, and multiple attempts at cannulations. We conclude that, in patients undergoing ERCP who are at high risk of PEP, procedure-related factors should be monitored to reduce the risk of PEP. Multiple attempts at cannulation was the most significant risk factor in our study.

show abstract

Does Obesity Confer an Increased Risk and/or More Severe Course of Post-ERCP Pancreatitis?

Abstract: Obesity did not seem to confer an increased risk for ERCP-induced pancreatitis. A statistically significant association between obesity and the severity of ERCP-induced pancreatitis was not apparent.

Cited by 27 publications

References 26 publications

Effect of Obesity and Decompressive Laparotomy on Mortality in Acute Pancreatitis Requiring Intensive Care Unit Admission

Effect of Obesity and Decompressive Laparotomy on Mortality in Acute Pancreatitis Requiring Intensive Care Unit Admission

Death after endoscopic retrograde cholangiopancreatography: findings at autopsy

Post-ERCP pancreatitis and its related factors: A prospective study in Cipto Mangunkusumo National General Hospital

Contact Info

Product

Resources

About