Post-ERCP pancreatitis in 2364 ERCP procedures: is intraductal ultrasonography another risk factor?
Autor: | Dirk Domagk, Hauke Heinzow, R. Hoehr, Wolfram Domschke, T Meister, Achim Heinecke |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male medicine.medical_specialty Pancreatic disease Adolescent Gastroenterology Endosonography Young Adult Risk Factors Internal medicine medicine Humans Risk factor Prospective cohort study Aged Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Hazard ratio Lipase Middle Aged medicine.disease digestive system diseases surgical procedures operative Pancreatitis Acute pancreatitis Female Bile Ducts business Biomarkers Cohort study |
Zdroj: | Endoscopy. 43:331-336 |
ISSN: | 1438-8812 0013-726X |
Popis: | BACKGROUND AND STUDY AIMS: Acute pancreatitis is considered a relevant major complication following endoscopic retrograde cholangiopancreatography (ERCP); according to literature data, the incidence varies between 1.5 % and 17 %. In the present study, we aimed to identify potentially new, hitherto unknown risk factors for post-ERCP pancreatitis. PATIENTS AND METHODS: A total of 2364 ERCP procedures performed in 1275 patients during the years 2004 - 2008 were included in the study. Post-ERCP pancreatitis was defined as acute abdominal pain within 48 hours following ERCP with at least 3-fold elevated levels of serum lipase and a requirement for analgesic drugs for at least 24 hours. The severity of the pancreatitis was determined using the Imrie score. RESULTS: In our cohort study a total of 54 different patients (2.3 %) developed post-ERCP pancreatitis. In 50 of these patients (92.6 %) the pancreatitis was mild; in 54 (7.4 %) it was severe. Patients with post-ERCP pancreatitis had highly significantly lower bilirubin levels than patients who did not have post-ERCP pancreatitis ( P < 0.001). Length of hospital stay, duration of analgesics, and need for analgesic drugs were significantly higher in patients suffering from severe pancreatitis ( P ≤ 0.01). In multivariate analysis, among other, already well-described risk factors we identified intraductal ultrasonography as another risk factor for post-ERCP pancreatitis, with a hazard ratio of 2.41 ( P = 0.004). CONCLUSIONS: According to our retrospective data, intraductal ultrasonography seems to be another independent risk factor for developing post-ERCP pancreatitis, which needs to be further elucidated in prospective studies. |
Databáze: | OpenAIRE |
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