Risk factors of acute pancreatitis after endoscopic retrograde cholangiopancreatography

Abstract

Objective To investigate the risk factors of acute pancreatitis after endoscopic retrograde chloangiopancreatography (ERCP). Methods Clinical date of 1 041 patients who underwent therapeutic ERCP from January 2016 to August 2017 in department of gastroenterology, Zhongnan Hospital of Wuhan University, were retrospectively studied. Among them post-ERCP pancreatitis developed in 53 patients (PEP group) and the remaining 988 patients were assigned in the non-PEP group. The clinical characteristics, procedures of ERCP, gastrointestinal symptoms and laboratory findings after ERCP were compared between two groups. The SPSS software (version 22.0) was applied to analyze the risk factors of PEP. Results The overall incidence rate of PEP was 5.09% (53/1 041). There were statistic difference in the number of white cells [8.56 (5.43, 12.23) ×109/L vs. 7.12 (5.58, 9.20) ×109/L, Z=-2.122] and the ratio of neutrophils [0.82±0.11 vs. 0.76±0.12, t=-3.612] after ERCP operation; the incidence of endoscopic sphincterotomy (EST) [60.37%(32/53) vs. 43.72% (432/988) , χ2=5.646] and endoscopic papillary balloon dilation (EPBD)[50.94% (27/53) vs. 33.00% (326/988) , χ2=7.230] during operation, and periampullary diverticula [35.85% (19/53) vs. 52.98% (523/988) , χ2=4.619] (all P<0.05). Logistic analysis indicated that the ratio of neutrophils was independent risk factor of PEP (OR=1.058, 95%CI: 1.019-1.098, P=0.003) . Conclusion The number of white cells, the ratio of neutrophils after ERCP and endoscopic sphincterotomy, endoscopic papillary balloon dilation and periampullary diverticula are associated with PEP, while the ratio of neutrophils is the independent risk factor of PEP. Key words: Cholangiopancreatography, endoscopic retrograde; Pancreatitis; Risk factors