Comparison of Endoscopic Ultrasonography with Secretin-enhanced MR cholangiopancreatography for etiologic diagnosis in idiopathic acute pancreatitis

Abstract

s / Pancreatology 15 (2015) S1eS141 S53 remains a challenge to assess the accurate indications for ERCP in patients with suspected choledocholithiasis and to select high risk PEP patients for appropriate prevention. Aims: The aim was to evaluate PEP prevalence and analyse patient's predictive factors of PEP in suspected choledocholithiasis prior ERCP. Patients & methods: 270 patients undergone ERCP due to suspected choledocholithiasis from 2012-2014y. Mean age was 65y (range 21-96y), 66% were females. The PEP prevalence were analysed. Patients were grouped using American Society of Gastrointestinal Endoscopy (ASGE,2010) outlined predictive factors, risk groups of choledocholithiasis prior ERCP. Univariate, multivariate analysis of choledocholithiasis and PEP risk factors were made. Results: Overall 16 patient's(6%) had PEP, 2(0,7%) hyperamylasemia. 2 cases were severe PEP with one lethal outcome. Choledocholithiasis was confirmed in 139(51%) patients, 10 occured PEP. All patients were in high risk group of PEP (according to ESGE,2014). 195(72%) patients had high risk, 75 intermediate risk of choledocholithiasis according to ASGE guidelines. PEP occured in 13 cases of high(p1⁄40,067), 3 intermediate group(p1⁄40,04). No risk factor significantly increased risk of PEP by univariate analysis. Abnormal liver biochemical test other than bilirubin (OR 0,857, p1⁄40,0001) and age>55y (OR 0,664, p1⁄40,020) increased risk by multivariate analysis. PEP was in 19% of age 18-45y, 17% 46-65y, 25% 66-85y. Choledocholithiasis mostly was in age 66-85y(28%). Conclusion: Patients with high risk of choledocholithiasis have higher risk of PEP comparing to intermediated risk. Patient's age >55y in suspected choledocholithiasis is additional predictive factor of PEP.