Post-ERCP pancreatitis and its related factors: A prospective study in Cipto Mangunkusumo National General Hospital

Abstract

Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is a widely used procedure for the diagnosis and treatment of pancreatobiliary disease with post-ERCP pancreatitis (PEP) is the most common complication. The goal of this study was to comprehensively evaluate the potential patient- and procedure-related risk factors for PEP. Methods: A 25-variable database was compiled from information collected before, during, and 24-72 h after ERCP for 238 patients who underwent diagnostic or therapeutic ERCP in Cipto Mangunkusumo General National Hospital, Jakarta. The grading of acute pancreatitis was classified using the modified Glasgow (Imrie′s) severity criteria. Results: The average age was 51 years, and most patients were men and were overweight. Sixty-three patients (26.5%) were diagnosed with PEP, and 33 of these (52.4%) were classified as having severe pancreatitis. We applied univariate analysis to analyze the data contained in the 25-variable database to identify patient- and procedure-related predictors of PEP. We found significant correlations between PEP and the patient-related factor common bile duct stenosis (P < 0.05), and between PEP and the three procedure-related factors procedure time, cannulation time, and multiple cannulation attempts (P < 0.05). Multivariate analysis showed that multiple attempts at cannulations was the only significant risk factor for PEP. Conclusions: In our study, four variables were associated with PEP: Common bile duct stenosis, procedure time, cannulation time, and multiple attempts at cannulations. We conclude that, in patients undergoing ERCP who are at high risk of PEP, procedure-related factors should be monitored to reduce the risk of PEP. Multiple attempts at cannulation was the most significant risk factor in our study.