Risk factors of post ERCP pancreatitis in young patients after endoscopic papillary balloon dilation

Abstract

Objective To determine the risk factors of post ERCP pancreatitis (PEP) in young patients after endoscopic papillary balloon dilatation (EPBD). Methods A retrospective analysis was performed on 357 consecutive young patients with common bile duct stones (CBDS) who had undergone EPBD, and the clinical and endoscopic data were collected. The risk factors of PEP after CBDS removal by EPBD were analyzed by using univariate and multivariate logistic regression. Results Twenty nine patients developed PEP after CBDS removal by EPBD, and the PEP rate was 8.1%. And the PEP rate was associated with female, serum total bilirubin, AST, γ GT, size of CBDS, time of cannulation and guidewire into pancreatic duct, balloon diameter and dilation duration, but it was not significantly associated with age, number of CBDS, pre-EPBD EST, pancreatic stent placement. Univariate logistic regression analysis showed that female, pre-ERCP bilirubin 10 times, guidewire into pancreatic duct >3 times, balloon diameter ≥15 mm and dilation duration ≥3 min were significantly related with PEP after EPBD procedure (P<0.05). The following multivariate logistic regression indicated only female, pre-ERCP bilirubin <17.1 μmol/L and dilation duration ≥3 min were significantly related with PEP after EPBD procedure (P<0.05). Conclusions Female, pre-ERCP total bilirubin <17.1 μmol/L and dilation times ≥3 min are risk factors of PEP for young patients after CBDS removal by EPBD. Therefore, for female young patient without jaundice, long time dilation with large balloon should be avoided. Key words: Cholangiopancreatography, endoscopic retrograde; Balloon dilatation; Pancreatitis; Risk factors