Practice Patterns and Use of Endoscopic Retrograde Cholangiopancreatography in the Management of Recurrent Acute Pancreatitis
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Background/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While somephysicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicatedin patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAPin the US. Methods: An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use wasapproved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practicepatterns in the management of RAP in multiple clinical scenarios. Results: The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomiallogistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) foroffering ERCP. Conclusions: A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centersin the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendationfor ERCP
Abstract
Background/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While somephysicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicatedin patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAPin the US. Methods: An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use wasapproved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practicepatterns in the management of RAP in multiple clinical scenarios. Results: The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomiallogistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) foroffering ERCP. Conclusions: A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centersin the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendationfor ERCP
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