Incidence and risk factors for post-ERCP pancreatitis in chronic pancreatitis

Published on Sep 1, 2017in Gastrointestinal Endoscopy6.89
· DOI :10.1016/J.GIE.2016.12.020
Zhen-Hua Zhao3
Estimated H-index: 3
('SMMU': Second Military Medical University),
Liang-Hao Hu17
Estimated H-index: 17
('SMMU': Second Military Medical University)
+ 11 AuthorsZhuan Liao19
Estimated H-index: 19
('SMMU': Second Military Medical University)
Background and Aims Almost all studies on post-ERCP pancreatitis (PEP) have mainly involved patients with biliary diseases rather than chronic pancreatitis (CP), and the concept that CP seems to be a protective factor associated with PEP has not been studied in detail. The aim of this study was to determine the incidence of PEP in patients with CP at different clinical stages and to identify the predictive and protective factors of PEP in a large cohort. Methods In this observational cohort study, medical records of patients with CP (CP group) and biliary diseases (BD group) in a tertiary hospital from January 2011 to May 2015 were examined. The difference in the incidence of PEP between CP group and BD group and the risk of PEP at different clinical stages of CP were calculated by the χ 2 test or the Fisher exact test. The predictive and protective factors for PEP were investigated by univariate and multivariate analysis. Results In total, 2028 ERCP procedures were performed in 1301 patients with CP and 2000 procedures in 1655 patients with BD. The overall incidence of PEP in CP group (4.5%) was similar to that in the BD group (4.8%; P  = .747). However, CP patients had significantly lower rates of moderate and severe attacks (0% vs 1.3%, P Conclusions Compared with BD patients, CP patients had similar incidence of PEP overall but lower grades of severity. The incidence of PEP in CP patients decreased significantly with disease progression. (Clinical trial registration number: NCT02781987.)
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