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

Abstract

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.

Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography versus Endoscopic Ultrasonography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis: The Indonesian Experience

“…In addition, the percentage of deaths occurring as a consequence of any complication of ERCP has been reported to be 0.33% [ 5 , 6 ]. A higher rate of PEP of 26.5% was reported in a prospective study conducted in our hospital [ 7 ]. ERCP is reserved exclusively for therapeutic purposes because of the risks, and EUS and MRCP have become the modalities of choice for diagnosing choledocholithiasis [ 1 - 3 ].…”

Post-ERCP pancreatitis: Frequency and risk stratification from four tertiary care referral hospitals in South East Asia

“…Other studies from the various country also found male predominance. [15][16][17] Regarding the indications of ERCP, choledocholithiasis was the most common indication found in nearly half of the study subjects, followed by Cholangiocarcinoma, periampullary carcinoma, and carcinoma head of the pancreas. A prospective study also found the highest cases of choledocholithiasis (32%) as an indication of ERCP, whereas cholangiocarcinoma and carcinoma head of pancreas as the second-highest indications.…”

Role of 4-H serum lipase level in predicting postendoscopic retrograde cholangiopancreatography pancreatitis

“…A study on 238 subjects in Indonesia reported PEP to occur in 63 (26%) cases. [ 17 ] Another study in Ohio, USA, found 23% PEP. [ 18 ] Another recent study on 300 cases reported 11.7% of PEP.…”