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The number of wire placement in the pancreatic duct and metal biliary stent as risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis.
Shin, Seung Hwan; So, Hoonsub; Cho, Sunghee; Kim, Nayoung; Baik, Gwang Ho; Lee, Sung Koo; Park, Do Hyun.
Afiliação
  • Shin SH; Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • So H; Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • Cho S; GI Endoscopy Center.
  • Kim N; Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • Baik GH; Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • Lee SK; Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • Park DH; Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Gastroenterol Hepatol ; 35(7): 1201-1207, 2020 Jul.
Article em En | MEDLINE | ID: mdl-31830336
ABSTRACT
BACKGROUND AND

AIM:

Many post-ERCP pancreatitis (PEP) risk factors, including pancreatic duct cannulation, have been identified; however, whether the number of repeated and unintentional wire placements (WPs) in the pancreatic duct during wire-guided cannulation affects PEP risk is unknown. We aimed to identify the effects of repeated WP in the pancreatic duct and other potential risk factors on PEP incidence.

METHODS:

We retrospectively analyzed 877 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP). We examined potential patient-related and procedure-related risk factors, and PEP incidence by univariable and multivariable logistic regression analyses.

RESULTS:

Thirty-four patients (3.9%) had PEP. Univariable analysis revealed younger age, malignant common bile duct or ampulla of Vater stricture, two or more episodes of WPs in the pancreatic duct, and metal biliary stent as risk factors for PEP. Following multivariable analysis, two or more episodes of WPs in the pancreatic duct and metal biliary stent remained in the final model. PEP did not increase significantly in case of a one episode of WP (4.0%) compared with no episode of WP in the pancreatic duct (2.7%). However, patients with two episodes of WPs had 8.0% incidence and three or more episodes of WPs had 14.3%.

CONCLUSIONS:

A WP in the pancreatic duct and a metal biliary stent were associated with increased PEP incidence in patients undergoing ERCP. As for the pancreatic duct wire cannulation, two or more WPs considerably increased PEP incidence. This suggests that preventive measures or alternative procedures might be considered in patients with such cases during and after ERCP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ductos Pancreáticos / Pancreatite / Cateterismo / Stents / Colangiopancreatografia Retrógrada Endoscópica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ductos Pancreáticos / Pancreatite / Cateterismo / Stents / Colangiopancreatografia Retrógrada Endoscópica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article