Impact of ERCP Timing on the Incidence of Post-ERCP Pancreatitis

Abstract

Introduction: Post-ERCP pancreatitis (PEP) is a potential major complication of endoscopic retrograde cholangiopancreatography (ERCP). The impact of ERCP timing on PEP is not known. Methods: A retrospective, cohort study was conducted to elucidate the relationship between BMI and PEP in all patients who underwent ERCP in a tertiary referral center from January 2009 to October 2016. Patient characteristics and procedure details were collected. PEP was defined by consensus criteria. Multivariable logistic regression was used to determine the association between ERCP timing and PEP. Results: PEP was diagnosed in 84 out of 1789 (4.7%) ERCP performed during the regular working hours (7AM-5 PM) and in 23 out of 447 (5.2%) RR 1.1 (0.67-1.7) p=0.69. Multivariate analysis showed that female < 40 years of age, contrast injection into the pancreatic duct, biliary sphincterotomy, pancreatic sphincterotomy, failed PD stent placement, and difficult cannulation were associated with PEP. In the multivariate model timing of the ERCP was not associated with PEP OR 1.2 (0.7-2.0) p=0.42 Conclusion: Timing of the ERCP does not increase the the risk of PEP.