Small common bile duct - the risk factor for post-ercp pancreatitis in patients with choledocholithiasis
1
Surgery 6, Kharkiv National Medical University, Ukraine
2
Surgery 2, Poltava State Medical University, Ukraine
3
Gastroenterology, Salisbury NHS Foundation Trust, United Kingdom
Submission date: 2024-05-24
Final revision date: 2024-09-17
Acceptance date: 2024-10-23
Publication date: 2025-01-30
Wiadomości Lekarskie 2024;77(12):2388-2393
KEYWORDS
TOPICS
ABSTRACT
Aim:
to investigate the risk factors for PEP in patients with choledocholithiasis
Material and methods:
We have retrospectively analyzed 253 cases with choledocholithiasis that underwent ERCP. The primary endpoint was the occurrence of PEP. A number of potential risk factors for PEP were taken into account: gender, age (< 60 or ≥ 60 years); blood total bilirubin level (normal or increased); common bile duct size (≤10 or >10 mm); type of choledocholithiasis - microcholedocholithiasis, choledocholithiasis (1-2 stones), multiple choledocholithiasis (≥ 3 stones) and choledocholithiasis due to Mirizzi syndrome; periampullary diverticulum; papilla size (≤5 or >6 mm); ERCP success; selective biliary cannulation; pancreatic cannulation/injection; precut; papillotomy.
Results:
PEP was in 8 (3,2 %) cases. Univariate analysis identified two factors associated with PEP – common bile duct ≤10 mm (P=0.045) and papilla ≤5 mm (P=0.036). In multivariate analysis, among all variables only the common bile size ≤10 mm appeared to be significant (P=0.018).
Conclusions:
In patients with choledocholithiasis the occurrence of PEP is related to common bile duct size less than 10 mm.
to investigate the risk factors for PEP in patients with choledocholithiasis
Material and methods:
We have retrospectively analyzed 253 cases with choledocholithiasis that underwent ERCP. The primary endpoint was the occurrence of PEP. A number of potential risk factors for PEP were taken into account: gender, age (< 60 or ≥ 60 years); blood total bilirubin level (normal or increased); common bile duct size (≤10 or >10 mm); type of choledocholithiasis - microcholedocholithiasis, choledocholithiasis (1-2 stones), multiple choledocholithiasis (≥ 3 stones) and choledocholithiasis due to Mirizzi syndrome; periampullary diverticulum; papilla size (≤5 or >6 mm); ERCP success; selective biliary cannulation; pancreatic cannulation/injection; precut; papillotomy.
Results:
PEP was in 8 (3,2 %) cases. Univariate analysis identified two factors associated with PEP – common bile duct ≤10 mm (P=0.045) and papilla ≤5 mm (P=0.036). In multivariate analysis, among all variables only the common bile size ≤10 mm appeared to be significant (P=0.018).
Conclusions:
In patients with choledocholithiasis the occurrence of PEP is related to common bile duct size less than 10 mm.
REFERENCES (20)
1.
Cianci P, Restini E. Management of cholelithiasis with choledocholithiasis: Endoscopic and surgical approaches. World J Gastroenterol. 2021 Jul 28;27(28):4536-4554. doi: 10.3748/wjg.v27.i28.4536.
2.
Fujita K, Yazumi S, Matsumoto H, Asada M, Nebiki H, Matsumoto K, Maruo T, Takenaka M, Tomoda T, Onoyama T, Kurita A, Ueki T, Katayama T, Kawamura T, Kawamoto H; Bilio-pancreatic Study Group of West Japan. Multicenter prospective cohort study of adverse events associated with biliary endoscopic retrograde cholangiopancreatography: Incidence of adverse events and preventive measures for post-endoscopic retrograde cholangiopancreatography pancreatitis. Dig Endosc. 2022 Sep;34(6):1198-1204. doi: 10.1111/den.14225. Epub 2022 Feb 4. PMID: 34963021; PMCID: PMC9540598.
3.
Parvin S, Islam MS, Majumdar TK, Azam MG, Islam MS, Begum MR, Hossain MA, Imam I, Ahmed F. Post-ERCP pancreatitis: Frequency and risk stratification from four tertiary care referral hospitals in South East Asia. Medicine (Baltimore). 2022 Aug 26;101(34):e30216. doi: 10.1097/MD.0000000000030271.
4.
Li GZ, Wang F, Fang J, Zha HL, Zhao Q. Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Evidence from 1786 Cases. Med Sci Monit. 2018 Nov 26;24:8544-8552. doi: 10.12659/MSM.913314.
5.
Shimamura T, Miyahara K, Takamori A, Hidaka H, Ito Y, Fujimoto S, Takedomi H, Tsuruoka N, Sakata Y, Eguchi Y, Node K, Noda T, Fujimoto K. Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan. Digestion. 2020;101(5):557-562. doi: 10.1159/000501309.
6.
Rivas A, Pherwani S, Mohamed R, Smith ZL, Elmunzer BJ, Forbes N. ERCP-related adverse events: incidence, mechanisms, risk factors, prevention, and management. Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(11):1101-1116. doi: 10.1080/17474124.2023.2277776.
7.
Wu CCH, Lim SJM, Khor CJL. Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management. Clin Endosc. 2023 Jul;56(4):433-445. doi: 10.5946/ce.2023.013.
8.
Chen JJ, Wang XM, Liu XQ, Li W, Dong M, Suo ZW, Ding P, Li Y. Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years. Eur J Med Res. 2014 May 15;19(1):26. doi: 10.1186/2047-783X-19-26.
9.
Syrén E, Eriksson S, Enochsson L, Eklund A, Sandblom G. Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography. BJS Open. 2019 Apr 2;3(4):485-489. doi: 10.1002/bjs5.50162. PMID: 31406957; PMCID: PMC6681151.
10.
Ito K, Fujita N, Kanno A, Matsubayashi H, Okaniwa S, Nakahara K, Suzuki K, Enohara R; Post-ERCP Pancreatitis Prevention by Pancreatic Duct Stenting Research Group (PEP Study Group), Japan. Risk factors for post-ERCP pancreatitis in high risk patients who have undergone prophylactic pancreatic duct stenting: a multicenter retrospective study. Intern Med. 2011;50(24):2927-32. doi: 10.2169/internalmedicine.
11.
Kakutani H, Hino S, Ikeda K, Koyama S, Mori N, Imazu H, Kawamura M, Tajiri H. Risk factors of post-ERCP pancreatitis at a tertiary referral center in Japan. Surg Laparosc Endosc Percutan Tech. 2014 Jun;24(3):270-3. doi: 10.1097/SLE.0b013e3182901461.
12.
Funatsu E, Masuda A, Takenaka M, Nakagawa T, Shiomi H, Yoshinaka H, Kobayashi T, Sakai A, Yagi Y, Yoshida M, Arisaka Y, Okabe Y, Kutsumi H, Azuma T. History of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Acute Pancreatitis as Risk Factors for Post-ERCP Pancreatitis. Kobe J Med Sci. 2017 May 15;63(1):E1-E8.
13.
Nakai Y, Isayama H, Sasahira N, Kogure H, Sasaki T, Yamamoto N, Saito K, Umefune G, Akiyama D, Kawahata S, Matsukawa M, Saito T, Hamada T, Takahara N, Mizuno S, Miyabayashi K, Mohri D, Hirano K, Tada M, Koike K. Risk factors for post-ERCP pancreatitis in wire-guided cannulation for therapeutic biliary ERCP. Gastrointest Endosc. 2015 Jan;81(1):119-26. doi: 10.1016/j.gie.2014.06.005.
14.
Lin Y, Liu X, Cao DQ, Tang JH, Wen JJ, Li TF, Liu PF, Xia TS. Analysis of risk factors and prevention strategies of post-ERCP pancreatitis. Eur Rev Med Pharmacol Sci. 2017 Nov;21(22):5185-5190. doi: 10.26355/eurrev_201711_13838.
15.
He QB, Xu T, Wang J, Li YH, Wang L, Zou XP. Risk factors for post-ERCP pancreatitis and hyperamylasemia: A retrospective single-center study. J Dig Dis. 2015 Aug;16(8):471-8. doi: 10.1111/1751-2980.12258.
16.
Köseoğlu H, Solakoğlu T, Başaran M, Özer Sarı S, Tahtacı M, Yaman S, Selvi E, Ersoy O. Risk factors for post-ERCP pancreatitis: it depends on the ERCP indication. Acta Gastroenterol Belg. 2020 Oct-Dec;83(4):598-602.
17.
Hadi YB, Naqvi SF, Abdelqader A, Kupec J, Nasr J. Reduced risk of post ERCP pancreatitis in statin users. BMC Gastroenterol. 2020 Apr 23;20(1):125. doi: 10.1186/s12876-020-01264-5.
18.
Dumonceau JM, Kapral C, Aabakken L, Papanikolaou IS, Tringali A, Vanbiervliet G, Beyna T, Dinis-Ribeiro M, Hritz I, Mariani A, Paspatis G, Radaelli F, Lakhtakia S, Veitch AM, van Hooft JE. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020 Feb;52(2):127-149. doi: 10.1055/a-1075-4080. Epub 2019 Dec 20. PMID: 31863440.
19.
Mamontov IM, Tamm TI, Kramarenko KO, Ryabushchenko DD, Sytnik DA, Nepomniashchyi VV. Risk factors for post-endoscopic retrograde pancreatography pancreatitis in malignant extrahepatic biliary obstruction: a retrospective single-center study. Ukrainian journal of radiology and oncology. 2023;31(2):150–160. DOI: https://doi.org/10.46879/ukroj....
20.
Poon E., Feng C.. Univariate and Multiple Regression Analyses in Medical Research. Biometrical Letters. 2023;60(1): 65-76. https://doi.org/10.2478/bile-2....
| eISSN: | 2719-342X |
| ISSN: | 0043-5147 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
