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DOI: 10.1055/s-0030-1256194
© Georg Thieme Verlag KG Stuttgart · New York
Post-ERCP pancreatitis in 2364 ERCP procedures: is intraductal ultrasonography another risk factor?
Publikationsverlauf
submitted 21 December 2009
accepted after revision 11 October 2010
Publikationsdatum:
16. März 2011 (online)
![](https://www.thieme-connect.de/media/endoscopy/201104/lookinside/thumbnails/10.1055-s-0030-1256194-1.jpg)
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.
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1 The first two authors, T. Meister and H. Heinzow, contributed equally to this work.
D. DomagkMD
Department of Medicine B
University of Münster
Albert-Schweitzer-Str. 33
48149 Münster
Germany
Fax: +49-251-8347576
eMail: domagkd@uni-muenster.de