Endoscopy 2018; 50(04): S199
DOI: 10.1055/s-0038-1637652
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

IS DIFFICULT CANNULATION THE MAIN RISK FACTOR FOR POST-ERCP PANCREATITIS DESPITE OF PROPHILACTIC PANCREATIC STENT? A RETROSPECTIVE SINGLE-CENTER STUDY

V Sandru
1   Clinical Emergency Hospital Bucharest- UMF Carol Davila, Gastroenterology and Interventional Endoscopy, Bucharest, Romania
,
M Ilie
1   Clinical Emergency Hospital Bucharest- UMF Carol Davila, Gastroenterology and Interventional Endoscopy, Bucharest, Romania
,
O Plotogea
1   Clinical Emergency Hospital Bucharest- UMF Carol Davila, Gastroenterology and Interventional Endoscopy, Bucharest, Romania
,
B Ungureanu
2   County Emergency Clinical Hospital Craiova – UMF Craiova, Gastroenterology, Craiova, Romania
,
I Moroi
3   Clinical Emergency Hospital Bucharest, Gastroenterology and Interventional Endoscopy, Bucharest, Romania
,
G Balan
4   UMF Grigore T. Popa – Iasi, Gastroenterology, Iaşi, Romania
,
G Constantinescu
1   Clinical Emergency Hospital Bucharest- UMF Carol Davila, Gastroenterology and Interventional Endoscopy, Bucharest, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available ateRef
 

Aims:

The aim of this study is to examine other potential patient- and procedure-related risk factors besides difficult cannulation and despite of prophylactic pancreatic stents insertion.

Methods:

This paper is a retrospective study from January 2015 to August 2017 conducted in Clinical Emergency Hospital Bucharest. We enrolled 178 patients that presented difficult cannulation and to whom pancreatic stents were inserted for a prophylactic purpose. Still, 25 patients of all, were diagnosed with post-ERCP pancreatitis (PEP). We analyzed each patient in terms of risk factors for PEP, by comparing the two groups.

Results:

PEP was diagnosed following the Cotton's criteria: abdominal pain developed on the day following ERCP and the serum amylase level was 3 times higher than normal upper limit. The median age was similar in the two groups (59 vs. 61 years old, p = 0.473), the female gender was also predominant in both groups (p = 0.159). Benign indication was more frequently encountered in patients who developed PEP (p < 0.005). 20% of the patients with PEP had suspected sphincter of Oddi dysfunction (p < 0.005); 14 patients had normal serum bilirubin (p < 0.005). Patients with pancreatic cancer did not develop PEP. Precut sphincterotomy was performed in almost half of the cases with PEP (48%).

Conclusions:

We conclude that the following additional risk factors influence the occurrence of PEP. Normal serum bilirubin has a 2.16 risk for PEP, while sphincter of Oddi dysfunction provides an extra 2.66 risk. Pancreatic cancer seems to be a “protective” factor for PEP, since none of these patients developed PEP. We also noticed that precut sphincterotomy does not modify the risk for PEP, whether it was done before or after stent insertion. The age and gender as well, are not influencing the risk for PEP, as we introduced in the study only patients with difficult cannulation and prophylactic pancreatic stent.