TITLE

Risk Factors for ERCP-Related Complications: A Prospective Multicenter Study

AUTHOR(S)
Peng Wang; Zhao-Shen Li; Feng Liu; Xu Ren; Nong-Hua Lu; Zhi-Ning Fan; Qiang Huang; Xiao Zhang; Li-Ping He; Wen-Sheng Sun; Qiu Zhao; Rui-Hua Shi; Zi-Bin Tian; Yan-Qing Li; Wen Li; Fa-Chao Zhi
PUB. DATE
January 2009
SOURCE
American Journal of Gastroenterology;Jan2009, Vol. 104 Issue 1, p31
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: To investigate the potential risk factors for endoscopic retrograde cholangiopancreatography (ERCP) complications and to identify whether the risk factors are different for pancreatitis and asymptomatic hyperamylasemia. METHODS: Consecutive ERCP procedures were studied at 14 centers in China from May 2006 to April 2007. The complications after the patients' first-only procedures were evaluated. Multivariate analysis based on the first-only procedures was used to identify the risk factors. RESULTS: A total of 3,178 procedures were performed on 2,691 patients. Overall, complications developed in 213 (7.92%) patients, pancreatitis in 116 (4.31%), and asymptomatic hyperamylasemia in 396 (14.72%). In the multivariate analysis, female gender (adjusted odds ratios (ORs): 1.52, 95% confidence interval (CI): 1.14 - 2.02, P = 0.004), periampullary diverticulum (OR: 2.02, 95% CI: 1.49 - 2.73, P < 0.001), cannulation time >10 min (OR: 1.51, 95% CI: 1.08 - 2.10, P = 0.016), ≥ 1 pancreatic deep wire pass (OR: 1.80, 95% CI: 1.33 - 2.42, P < 0.001), and needle-knife precut (OR: 2.70, 95% CI: 1.42 - 5.14, P = 0.002) were risk factors for overall complications. Female gender (OR: 1.84, 95% CI: 1.25 - 2.70, P = 0.002), age ≤ 60 year (OR: 1.59, 95% CI: 1.06 - 2.39, P = 0.025), cannulation time >10 min (OR: 1.76, 95% CI: 1.13 - 2.74, P = 0.012), ≥ 1 pancreatic deep wire pass (OR: 2.77, 95% CI: 1.79 - 4.30, P < 0.001), and needle-knife precut (OR: 4.34, 95% CI: 1.92 - 9.79, P < 0.001) were risk factors for pancreatitis. Cannulation time >10 min (OR: 1.96, 95% CI: 1.52 - 2.54, P < 0.001), ≥ 1 pancreatic deep wire pass (OR: 2.24, 95% CI: 1.74 - 2.89, P < 0.001), needle-knife precut (OR: 2.34, 95% CI: 1.32 - 4.14, P = 0.004), and major papilla pancreatic sphincterotomy (OR: 1.71, 95% CI: 1.23 - 2.37, P = 0.001) were risk factors for asymptomatic hyperamylasemia. CONCLUSIONS: Patient-related factors are as important as procedure-related factors in determining high-risk predictors for post-ERCP overall complications and pancreatitis. However, the risk factors for asymptomatic hyperamylasemia may be mostly procedure related.
ACCESSION #
43984150

 

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