Effects of cannulation time on post-endoscopic retrograde cholangiopancreatography pancreatitis

Abstract

Objective To analyze the risk factors of post-ERCP pancreatitis (PEP) and to evaluate the relationship between cannulation time and PEP. Methods The data of cannulation time in 1 625 patients who underwent ERCP from 2010 to 2012 were retrospectively studied. The risk factors associated with PEP were analyzed by univariate and multivariate Logistic regression analysis. The effect of different cannulation time on PEP was evaluated. Results The incidence of overall PEP was 4.6%(75/1 625) including 4.1%(67/1 625)of mild and 0.5%(8/1 625)of moderate-to-severe. Univariate analysis revealed that diabetes mellitus (P=0.02), choledocholithiasis(P=0.02), malignant biliary stenosis (P=0.007), duodenal stenosis (P=0.029), precut (P<0.01), cannulation time≥8 min (P<0.01), blood platelet count≥180×109/L(P=0.089), alkaline phosphatase≥120 U/L(P=0.083)and total bilirubin≥17.1 μmol/L(P=0.094)were associated with PEP. Multivariate analysis revealed that precut (OR=1.93, 95%CI: 1.10-3.39, P=0.022), cannulation time ≥8 min (OR=3.50, 95%CI: 2.00-6.13, P<0.01) and duodenum stenosis (OR=2.92, 95%CI: 1.08-7.86, P=0.034) were independent risk factors of PEP. Within 30 min of cannulation, longer cannulation time was accompanied with higher PEP rate. Conclusion The cannulation time is an independent risk factor of PEP. Overall PEP is increased when cannulation time is more than 8 min. Key words: Cholangiopancreatography, endoscopic retrograde; Pancreatitis; Complications; Cannulation time