Abstract
BackgroundThe risk factors for post-ERCP cholecystitis (PEC) have not been characterized. Hence, this study aimed to identify the potential risk factors for PEC.MethodsThe medical records of 4238 patients undergoing the first ERCP in a single center from January 2012 to December 2016 were analyzed in this study. A multivariate analysis was used to identify the risk factors.ResultsThis study included 2672 patients who met the enrollment criteria. Of these, 36 patients (incidence rate of 1.35%) developed PEC within 2 weeks of the procedure. Univariate and multivariate analyses identified the following factors associated with PEC: history of acute pancreatitis [odds ratio (OR) = 2.60; 95% confidence interval (CI): 1.29–5.23], history of chronic cholecystitis (OR = 8.47; 95% CI: 2.54–28.24), gallbladder opacification (OR = 2.79; 95% CI: 1.37–5.70), biliary duct metallic stent placement (OR = 3.66; 95% CI: 1.78–7.54), and high leukocyte count before ERCP (OR = 1.10; 95% CI: 1.04–1.17). The prediction model incorporating these factors demonstrated an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.80–0.91). A prognostic nomogram was developed using the aforementioned variables to estimate the probability of PEC.ConclusionsThe risk factors, including the history of acute pancreatitis, history of chronic cholecystitis, gallbladder opacification, biliary duct metallic stent placement, and high leucocyte counts before ERCP, increased the occurrence of PEC and were positive predictors for PEC. The constructed nomogram was used to estimate the risk of PEC, guiding the implementation of prophylactic measures to prevent PEC in clinical practice.
Highlights
The risk factors for post-Endoscopic retrograde cholangiopancreatography (ERCP) cholecystitis (PEC) have not been characterized
1352 patients were excluded from the study due to concomitant acute cholecystitis (n = 182) or a history of cholecystectomy (n = 1170)
2672 patients with intact gallbladder were included in the retrospective analysis to analyze the incidence of acute cholecystitis within 2 weeks after the initial ERCP
Summary
The risk factors for post-ERCP cholecystitis (PEC) have not been characterized. This study aimed to identify the potential risk factors for PEC. Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure performed under visual and fluoroscopic guidance. It is widely used in diagnosing and treating of biliary and pancreatic diseases. ERCP is a technically challenging endoscopic procedure that can cause serious adverse events and occasionally even death. Possible ERCP-related adverse events include acute pancreatitis, hemorrhage, perforation, cholangitis, and acute cholecystitis. Post-ERCP pancreatitis (PEP) is the most common one with 9.7% incidence and 0.7% mortality rate [1]. Due to its high incidence, numerous studies have investigated the risk factors of PEP.
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