Increased Risk of Pancreatitis after Endoscopic Retrograde Cholangiopancreatography Following a Positive Intraoperative Cholangiogram: A Single-Center Experience
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Background/Aims: To determine if patients with a positive intraoperative cholangiogram (IOC) who undergo a subsequentendoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of post-ERCP pancreatitis (PEP) compared to thosewho undergo ERCP directly for suspected common bile duct stones. Methods: A retrospective case-control study was performed from 2010 to 2016. Cases included inpatients with a positive IOC atcholecystectomy who underwent subsequent ERCP. The control group included age-sex matched cohorts who underwent ERCP forcholedocholithiasis. Multivariate logistic regression was used to assess the association between PEP and positive IOC, adjusting formatching variables and additional potential confounders. Results: Of the 116 patients that met the inclusion criteria, there were 91 women (78%) in each group. Nine patients (7.8%)developed PEP in the IOC group, compared to 3 patients in the control group (2.6%). The use of pancreatic duct stents and rectalindomethacin was similar in both groups. After adjusting for age, sex, total bilirubin levels, and any stent placement, patients with apositive IOC had a significantly increased risk of PEP (odds ratio, 4.79; 95% confidence interval, 1.05–21.89; p<0.05). Conclusions: In this single-center case-control study, there was a five-fold increased risk of PEP following a positive IOC comparedto an age-sex matched cohort.
Abstract
Background/Aims: To determine if patients with a positive intraoperative cholangiogram (IOC) who undergo a subsequentendoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of post-ERCP pancreatitis (PEP) compared to thosewho undergo ERCP directly for suspected common bile duct stones. Methods: A retrospective case-control study was performed from 2010 to 2016. Cases included inpatients with a positive IOC atcholecystectomy who underwent subsequent ERCP. The control group included age-sex matched cohorts who underwent ERCP forcholedocholithiasis. Multivariate logistic regression was used to assess the association between PEP and positive IOC, adjusting formatching variables and additional potential confounders. Results: Of the 116 patients that met the inclusion criteria, there were 91 women (78%) in each group. Nine patients (7.8%)developed PEP in the IOC group, compared to 3 patients in the control group (2.6%). The use of pancreatic duct stents and rectalindomethacin was similar in both groups. After adjusting for age, sex, total bilirubin levels, and any stent placement, patients with apositive IOC had a significantly increased risk of PEP (odds ratio, 4.79; 95% confidence interval, 1.05–21.89; p<0.05). Conclusions: In this single-center case-control study, there was a five-fold increased risk of PEP following a positive IOC comparedto an age-sex matched cohort.
참고문헌 (19)
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