Risk factors for complications after performance of ERCP

Vandervoort, Jo; Soetikno, Roy; Tham, T. C. K.; Wong, Richard C.K.; Ferrari, Ângelo Paulo; Montes, Henry; Roston, Alfred; Slivka, Adam; Lichtenstein, David R.; Ruymann, F.; Dam, Jacques Van; Hughes, Mike; Carr‐Locke, David L.

doi:10.1016/s0016-5107(02)70112-0

Cited by 470 publications

(116 citation statements)

References 15 publications

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“…Bile stone disease, although the most frequent cause of first episode acute pancreatitis, is associated with one of the lowest risks of ICU admittance in this series of patients, which is consistent with several other reports [10,27,33]. Bile stone disease serves as reference in the analyses.…”

Section: Discussionsupporting

confidence: 90%

“…Huang, et al show that the rates of bile stone related ERCP procedures are roughly similar across gender [34], but this as well as other studies show that women are more at risk of ERCP associated acute pancreatitis (Table 2) [33,35,36]. Intervention towards bile stone disease reduce the risk of a second episode of acute pancreatitis, but it is a paradox that treatment strategy may imply further risk for patients and that less resources are devoted to causes of first episode of acute pancreatitis with higher risk of ICU admittance and recurrence.…”

Section: Discussionmentioning

confidence: 86%

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The Risk Factors of Intensive Care Unit Admittance during First Attack of Acute Pancreatitis

Dale¹,

Omdal²,

Lie³

et al. 2012

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Background: A proportion of patients with acute pancreatitis develop severe organ dysfunction requiring admittance in an intensive care unit. Patient characteristics associated with ICU admittance were evaluated in this consecutive series of patients. Methods: The clinical course of patients with first attack of acute pancreatitis in urban Norway between 01.01.1996 and 31.12.2006 was reviewed. Patient characteristics, comorbidity, pre hospital delay and likely aetiology of acute pancreatitis were analysed as risk factors for ICU admittance. Results: This study includes 565 patients, 299 women and 266 men (p = 0.089), with a median age of 60 years (range: 17 -98). 50 (9%) of the patients were admitted to the ICU. Men were more at risk than women for ICU admittance (OR 2.34; 95% CI: 1.27 -4.32). Patients with alcohol associated pancreatitis (OR 5.94; 95%, CI: 2.61 -13.53), miscellaneous aetiologies (OR: 2.81, 95% CI: 1.02 -7.73) and non-assessed aetiology (OR 2.71, 95%, CI: 1.26 -5.82) were more at risk of ICU admittance than patients with bile stones associated pancreatitis. Pre hospital delay increased the risk of ICU admittance amongst patients with alcohol associated pancreatitis (OR 4.23; 95%, CI: 1.11 -16.18). Two comorbid conditions conveyed increased risk (OR 8.78; 95%,). The case fatality rate was 24% in the ICU and 1.6% in the ward (OR 20.01, 95% CI: 7.71 -51.93). Conclusions: Aetiology of acute pancreatitis, especially alcohol, pre-hospital delay and male gender are associated with increased of risk of ICU admittance and increased fatality rate during first attack of AP.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 86%

The Risk Factors of Intensive Care Unit Admittance during First Attack of Acute Pancreatitis

Dale¹,

Omdal²,

Lie³

et al. 2012

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“…In general, post- ERCP pancreatitis and hyperamylasemia occur in 1.8-7.2 [1,2,3,4] and 60-70% of patients [5,6], respectively. Mann et al [7] reported that hyperamylasemia was related to the development of acute pancreatitis through neutrophil activation; therefore, a reduction in amylase levels is necessary to prevent post-ERCP pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

et al. 2015

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Background/Aims: Topical epinephrine application to the duodenal papilla reduces spasm of the sphincter of Oddi and prevents acute pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). Shakuyakukanzoto (TJ-68) has an inhibitory effect on muscle contraction. Therefore, TJ-68 potentially allows the relaxation of the sphincter of Oddi, which can aid in the prevention of post-ERCP pancreatitis. Methods: Thirty-six patients planned for ERCP were divided into TJ-68 (n = 17) and control groups (n = 19). In the TJ-68 group, the TJ-68 solution was endoscopically sprayed directly onto the duodenal papilla of patients. To assess the effects of TJ-68, serum amylase levels were measured at 1 h and 1 day after ERCP and symptoms were evaluated. Results: The serum amylase levels at 1 h after ERCP were 273.6 ± 212.0 IU/l in the TJ-68 group and 428.7 ± 281.6 IU/l in the control group, showing a statistically significant difference (p = 0.036). The serum amylase levels at 24 h after ERCP were 230.0 ± 182.7 IU/l in the TJ-68 group and 497.4 ± 514.0 IU/l in the control group (p = 0.011). Post-ERCP pancreatitis was observed in 0 and 4 patients (21.1%) in the TJ-68 and control groups, respectively, which was not statistically significant (p = 0.11). Conclusion: Direct TJ-68 solution application to the duodenal papilla significantly inhibited the elevation of serum amylase levels. However, the preventive effect regarding post-ERCP pancreatitis was not confirmed in this study.

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“…However, ERCP is associated with a relatively high complication rate. The reported incidence of complications ranges from 5% to 40%, depending on the complexity of the procedure, the underlying diagnosis, and patient co-morbidities [1]- [3]. Pancreatitis is seen as the most frequent complication of ERCP, followed by cholangitis, duodenal hemorrhage, and duodenal perforation [1]- [3].…”

Section: Introductionmentioning

confidence: 99%

“…The reported incidence of complications ranges from 5% to 40%, depending on the complexity of the procedure, the underlying diagnosis, and patient co-morbidities [1]- [3]. Pancreatitis is seen as the most frequent complication of ERCP, followed by cholangitis, duodenal hemorrhage, and duodenal perforation [1]- [3]. Post-ERCP pancreatitis is a feared complication that is associated with substantial morbidity and occasional mortality [4] [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of Post-ERCP Pancreatitis on Perioperative Factors of Pancreaticoduodenectomy

Hirashita¹,

Matsumoto²,

Izumi³

et al. 2015

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed for biliary drainage and examination of the biliary and pancreatic duct before pancreaticoduodenectomy (PD). The influence of preoperative post-ERCP pancreatitis on PD is unknown. The aim of this study was to evaluate the relation between post-ERCP pancreatitis before PD and surgical outcomes of PD. Methods: We examined 38 patients who underwent PD. The relations between post-ERCP pancreatitis before PD and perioperative factors of PD such as patient characteristics, operative findings, and postoperative course were evaluated with univariate and multivariate analyses. Results: Post-ERCP pancreatitis was observed in 12 (37.5%) of the 38 patients. Univariate analyses showed operative procedure (P = 0.034), operation time (P = 0.004), blood loss (P = 0.031), C-reactive protein (P = 0.043), and delayed gastric emptying (P = 0.035) to be significantly associated with post-ERCP pancreatitis. Multivariate analyses showed operation time (OR, 1.017; 95%CI, 1.000 -1.034; P = 0.049) and delayed gastric emptying (OR, 18.72; 95%CI, 1.139 -307.6; P = 0.040) to be significantly associated with post-ERCP pancreatitis. Conclusions: Post-ERCP pancreatitis was associated with prolonged operation time and delayed gastric emptying in patients undergoing PD.

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Risk factors for complications after performance of ERCP

Cited by 470 publications

References 15 publications

The Risk Factors of Intensive Care Unit Admittance during First Attack of Acute Pancreatitis

The Risk Factors of Intensive Care Unit Admittance during First Attack of Acute Pancreatitis

Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

Effect of Post-ERCP Pancreatitis on Perioperative Factors of Pancreaticoduodenectomy

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