Risk factors of pancreatitis after endoscopic sphincterotomy. Review of literature and practical remarks based on approximately 10,000 ERCPs
Journal Title: Polish Journal of Surgery - Year 2017, Vol 89, Issue 5
Abstract
Post-endoscopic pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Depending on the presence of risk factors, PEP can occur in 4,1% to about 43% of patients. According to the European Society of Gastrointestinal Endoscopy (ESGE) guidelines, only three to patient-associated risk factors have been identified: suspected sphincter of Oddi dysfunction (SOD) (OR 4.09), female gender (OR 2.23), and previous pancreatitis (OR 2.46). Another three procedure-associated factors include cannulation attempt duration > 10 minutes (OR 1.76), more than one pancreatic guidewire passage (OR 2.77, CI: 1.79 – 4.30), and pancreatic injection (OR 2.2, CI: 1.60 – 3.01). Importantly, analyses of cumulative risk due to coexistence of several factors emphasize the importance of female sex, difficult cannulation, CBD diameter <5 mm, young age, and many other factors. Unfortunately, studies performed to date have included only small numbers of patients with several co-existing risk factors. Therefore, further analysis of other risk factors and the cumulative risk related to their co-occurrence is necessary. Based on current evidence, special care must be given to patients with several risk factors. Also, care should be given to proper qualification of patients, use of guidewires, early pre-cut incision, protective Wirsung’s duct stenting, and rectal NSAID administration.<br/><br/>
Authors and Affiliations
Andrzej Jamry
Keywords
Related Articles
- EP ID EP230056
- DOI 10.5604/01.3001.0010.5409
- Views 64
- Downloads 0
The testing of an artificial modified bacterial cellulose auricle skeleton in an animal model
The aim of this study was to assess whether modified bacterial cellulose can be used for an artificial auricle skeleton. Introduction: The auricle is a part of the external ear. It consists of skin, cartilage, muscles an...
Diagnostyka i leczenie niewyjaśnionych krwawień do jelita cienkiego –analiza zastosowania enteroskopii dwubalonowej w algorytmie diagnostyczno-leczniczym w oparciu o materiał własny
Wstęp Niewyjaśnione krwawienie do przewodu pokarmowego (OGIB - obscure gastrointestinal bleeding) definiowane jest jako krwawienie do przewodu pokarmowego, które nie ustaje lub nawraca bez zdefiniowanej przyczyny, pomi...
Operacje jelita grubego u osób w podeszłym wieku
Wstęp: Wobec starzenia się społeczeństwa i wzrostu zachorowalności na raka jelita grubego, leczenie operacyjne pacjentów w podeszłym wieku staje się jednym z głównych wyzwań chirurgii koloproktologicznej. Cel: Celem bada...
Czynniki ryzyka zapalenia trzustki po endoskopowej sfinkterotomii. Przegląd literatury i kilka praktycznych uwag w oparciu o doświadczenia po przeprowadzeniu około 10 000 zabiegów ECPW
Najczęstszym powikłaniem po cholangiopankreatografii wstecznej (ECPW) jest zapalenie trzustki (post-endoscopic pancreatitis; PEP) (4,1–5,4%). Przy obecności czynników ryzyka odsetek ten może wzrosnąć do 29,2% (OR 14,9),...
The usefulness of D-dimer in diagnosis and prediction of venous thromboembolism in patients with abdominal malignancy
The aim: of the study was to evaluate the usefulness of D-dimer evaluation in the diagnosis and prediction of venous thromboembolism (VTE) of lower extremities in patients operated on for abdominal tumors depending on th...