Risk Factors for Pancreatitis and Cholecystitis after Endoscopic Biliary Stenting in Patients with Malignant Extrahepatic Bile Duct Obstruction
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Background/Aims: For the treatment of malignant biliary obstruction, endoscopic retrograde biliary drainage (ERBD) has been widelyaccepted as a standard procedure. However, post-ERBD complications can affect the lives of patients. The purpose of this study was toidentify the predictive factors for these complications, including the patient’s status, cancer status, and stent type. Methods: This was a retrospective analysis conducted in a single tertiary hospital from January 2007 to July 2017. The followingvariables were evaluated: sex, age, body mass index, cancer type, history of pancreatitis, gallbladder stone, previous biliary stenting, precutpapillotomy, stent type, contrast injection into the pancreatic duct or gallbladder, cystic duct invasion by the tumor, and occlusion ofthe cystic duct orifice by a metal stent. Results: Multivariate analysis showed that contrast injection into the pancreatic duct was a risk factor for pancreatitis. Patients with ahistory of bile drainage showed a lower risk of pancreatitis. For cholecystitis, the analysis revealed contrast injection into the gallbladderand cystic duct invasion by the tumor as important predictive factors. Metal stents showed a greater risk of post-procedure pancreatitisthan plastic stents, but did not affect the incidence of cholecystitis. Conclusions: Considering that contrast injection is the most important factor for both complications, a careful approach by thephysician is essential in preventing the occurrence of any complications. Further, choosing the type of stent is an important factor forpatients at a risk of post-procedure pancreatitis.
Abstract
Background/Aims: For the treatment of malignant biliary obstruction, endoscopic retrograde biliary drainage (ERBD) has been widelyaccepted as a standard procedure. However, post-ERBD complications can affect the lives of patients. The purpose of this study was toidentify the predictive factors for these complications, including the patient’s status, cancer status, and stent type. Methods: This was a retrospective analysis conducted in a single tertiary hospital from January 2007 to July 2017. The followingvariables were evaluated: sex, age, body mass index, cancer type, history of pancreatitis, gallbladder stone, previous biliary stenting, precutpapillotomy, stent type, contrast injection into the pancreatic duct or gallbladder, cystic duct invasion by the tumor, and occlusion ofthe cystic duct orifice by a metal stent. Results: Multivariate analysis showed that contrast injection into the pancreatic duct was a risk factor for pancreatitis. Patients with ahistory of bile drainage showed a lower risk of pancreatitis. For cholecystitis, the analysis revealed contrast injection into the gallbladderand cystic duct invasion by the tumor as important predictive factors. Metal stents showed a greater risk of post-procedure pancreatitisthan plastic stents, but did not affect the incidence of cholecystitis. Conclusions: Considering that contrast injection is the most important factor for both complications, a careful approach by thephysician is essential in preventing the occurrence of any complications. Further, choosing the type of stent is an important factor forpatients at a risk of post-procedure pancreatitis.
참고문헌 (21)
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