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Frequency and severity of post-ERCP pancreatitis correlated with extent of pancreatic ductal opacification

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Author(s)
Young Koog CheonKwang Bum ChoJames L. WatkinsLee McHenryEvan L. FogelStuart ShermanGlen A. Lehman
Keimyung Author(s)
Cho, Kwang Bum
Department
Dept. of Internal Medicine (내과학)
Journal Title
Gastrointestinal Endoscopy
Issued Date
2007
Volume
65
Issue
3
Abstract
Background: Pancreatitis is the most common complication of diagnostic and therapeutic ERCP. Almost certainly,
the etiology of this pancreatitis is multifactorial.
Objective: The primary objective of this study was to evaluate the relationship between the extent of pancreatic
ductal opacification and the frequency of pancreatitis.
Design: Retrospective study.
Setting: The ERCP database at our institution was searched for prospectively collected data from 1994 to 2005.
Patients and Interventions: A total of 14,331 ERCPs were included in the analysis. Patients were divided into 4
groups according to the extent of pancreatic duct opacification: group 1, no attempted opacification or failed
cannulation of the pancreatic duct (n Z 6739); group 2, opacification of head only (n Z 845); group 3, opacification
of head and body (n Z 2061); and group 4, opacification to the tail (n Z 4685). The incidence and
severity of pancreatitis was compared between and within each group.
Results: The overall pancreatitis rate was 4.0%. There was a progressively higher frequency of pancreatitis with
increased extent of opacification to the pancreatic ductal system (P!.001). The overall pancreatitis severity was
mild in 2.9%, moderate in 0.8%, and severe in 0.3% of cases. There was a significant difference in pancreatitis
severity between patients with pancreatogram (regardless of grade of filling) and patients without pancreatogram.
(P!.001). However, there was no difference in the pancreatitis severity between groups 2 to 4 (patients
with pancreatogram). Age (65 years vs O65 years), sex, and type of procedure performed (diagnostic and therapeutic)
were not significantly different beyond the extent of pancreatic ductal opacification. Multivariate analysis
showed that suspected sphincter of Oddi dysfunction with manometry and the extent of pancreatic duct
opacification were independent predictors of post-ERCP pancreatitis.
Conclusions: Less filling of the pancreatic ductal system was associated with less post-ERCP pancreatitis. Before
performing endoscopic retrograde pancreatography, endoscopists should carefully evaluate whether any pancreatogram
or what extent of pancreatogram is needed clinically. Greater use of noninvasive pancreatography
and less use of endoscopic retrograde pancreatography should decrease post-ERCP pancreatitis. (Gastrointest
Endosc 2007;65:385-93.)
Keimyung Author(s)(Kor)
조광범
Publisher
School of Medicine
Citation
Young Koog Cheon et al. (2007). Frequency and severity of post-ERCP pancreatitis correlated
with extent of pancreatic ductal opacification. Gastrointestinal Endoscopy, 65(3), 385–393. doi: 10.1016/j.gie.2006.10.021
Type
Article
ISSN
0016-5107
Source
https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(06)03123-3
DOI
10.1016/j.gie.2006.10.021
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35764
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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