Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Nov 2011)
Risk Factors for Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Hyperamylasemia
Abstract
BACKGROUND AND OBJECTIVE: Acute post ERCP pancreatitis (PEP) is still the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), and the reported incidence ranges between 5% and 20%. This difference reflects variety of patient populations, indications, definition of pancreatitis, endoscopic expertise and data collection methods. This study was designed to examine the incidents of post ERCP pancreatitis and hyperamylasemia and related risk factors from a tertiary academic medical center of North of IranMETHODS: This retrospective study was performed on all patients who underwent ERCP in Shahid Beheshti hospital (Babol Iran) during 2005-2009. Patients presented with acute pancreatitis and history of endoscopic sphincterotomy were excluded. Age, gender, CBD diameter, type of sphincterotomy, opium consumption and liver enzyme were the main variable for final analysis.FINDINGS: The overall incidence of PEP was 8.2% (43 of 525 patients) and post ERCP hypramilasemia developed in 34% of patients. In multivariate analysis, independent risk factors for PEP were: age less than 40 (OR=3/2, p<0.001) and needle knife Sphincterotomy (NKS) (OR=2/2 p<0.015). The independent risk factor of PERCP hyperamylasemia were age less than 40 (OR=1.8, p<0.04) and intact gallbladder without stone (OR=1.6, p<0.01). CONCLUSION: The results of this study show that young age is independently associated with post ERCP pancreatitis and hyperamylasemia. NKS increase PEP and intact gallbellader is predictor of post ERCP hyperamylasemia.
