ERCP induced acute pancreatitis: Risk assessment based on diagnostic and specific therapeutic cases

Abstract

ERCP INDUCED ACUTE PANCREATITIS: RISK ASSESSMENT BASED ON DIAGNOSTIC AND SPECIFIC THERAPEUTIC CASES. MF Catalano, JE Geenen, MI Schmalz, GK Johnson, DJ Geenen, WJ Hogan, and Midwest Pancreaticobiliary Group. St. Luke's Medical Center, Milwaukee, WI. Panereat~ is the most common major complication of diagnostic and therapeutic ERCT. Studies have reported the incidence of pancreatitis to be between 1-15% of all patient undergoing ERCP. The mechanism of injury during ERCP is unknown but likely includes chemical, thermal and mechanical factors. The rate of pancreatitis for specific therapeutic ERCP procedures has not been fully stratified. METHODS: The results of 2,954 patients undergoing ERCP for diagnostic 0,069) and therapeutic (1,885) were reviewed for cases of pancreatitis requiring hospitaliration. ~ t i c eases included sphincter of Oddi manometry (SOM) alone (315) or with sphincterotomy (176), sphineterotomy alone (571) or with stoat (225), stem alone (323), and others (266). Although other complications occurred including bleeding, perforation, and cholangitis; these were not considered in this study. Diagnosis of pancreatitis was defined as typical abdominal pain associated with elevation of amylase > 2 times normal values. RESULTS: Frequency of panereatitis in diagnostic cases was 4.7% compared to 10.9% in therapeutic eases. Rate of pancreatitis for specific therapeutic eases ranged from 6.0 to a high of 27.3%.