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Development and external validation of a nomogram for prediction of post-endoscopic retrograde cholangiopancreatography pancreatitis.
Fukuda, Rintaro; Hakuta, Ryunosuke; Nakai, Yousuke; Hamada, Tsuyoshi; Takaoka, Shinya; Tokito, Yurie; Suzuki, Yukari; Oyama, Hiroki; Kanai, Sachiko; Noguchi, Kensaku; Suzuki, Tatsunori; Ishigaki, Kazunaga; Saito, Kei; Saito, Tomotaka; Takahara, Naminatsu; Mizuno, Suguru; Ito, Yukiko; Kogure, Hirofumi; Fujishiro, Mitsuhiro.
Afiliação
  • Fukuda R; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hakuta R; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Nakai Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan. Electronic address: ynakai-tky@umin.ac.jp.
  • Hamada T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takaoka S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tokito Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki Y; Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
  • Oyama H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kanai S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Noguchi K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ishigaki K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Chemotherapy, The University of Tokyo Hospital, Tokyo, Japan.
  • Saito K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Saito T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takahara N; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Mizuno S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ito Y; Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
  • Kogure H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Fujishiro M; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Pancreatology ; 23(7): 789-796, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37666733
BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is widely performed for management of pancreatobiliary diseases; however, post-ERCP pancreatitis (PEP) remains as an unsolved problem. Although various risk factors for PEP have been reported, the prediction of PEP remains controversial. This study aimed to develop a predictive model for PEP. METHODS: Consecutive patients undergoing ERCP for biliary indications at two centers were retrospectively studied. Using data from a training cohort, we utilized a multivariable model to select five variables to construct a nomogram. The predictive model was internally and externally validated. Based on the nomogram, the patients were categorized into low-, moderate-, and high-risk groups. RESULTS: Using the data of 2224 patients in the training cohort, five variables were selected to generate a nomogram: 1) sex, 2) indication for ERCP, 3) difficult cannulation, 4) guidewire insertion into the pancreatic duct, and 5) endoscopic sphincterotomy or sphincteroplasty. The most significant risk factor was endoscopic papillary balloon dilation such as endoscopic sphincterotomy or sphincteroplasty. The bias-corrected concordance index was 0.72 in the training cohort and 0.72 in the validation cohort. Calibration curves for both cohorts demonstrated good agreement between the predicted and observed frequencies of the actual outcome. In the validation cohort, PEP developed in 5.0% and 14% of patients in the moderate- and high-risk groups, respectively. CONCLUSIONS: We successfully developed a good predictive model for PEP. The prevention of PEP in high risk patients should be investigated further.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite / Colangiopancreatografia Retrógrada Endoscópica Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite / Colangiopancreatografia Retrógrada Endoscópica Idioma: En Ano de publicação: 2023 Tipo de documento: Article