Is ESR Important for Predicting Post-ERCP Pancreatitis?

Clinical Medicine Insights. Gastroenterology Pub Date : 2015-05-05 eCollection Date: 2015-01-01 DOI:10.4137/CGast.S18938
Amir Houshang Mohammad Alizadeh, Esmaeil Shamsi Afzali, Catherine Behzad, Mirhadi Mousavi, Dariush Mirsattari, Siavash Zafar Doagoo, Mohammad Reza Zali
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引用次数: 6

Abstract

Background: Pancreatitis remains the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), resulting in substantial morbidity and occasional mortality. There are notable controversies and conflicting reports about risk factors of post-ERCP pancreatitis (PEP).

Aim: To evaluate the potential risk factors for PEP at a referral tertiary center, as a sample of the Iranian population.

Materials and methods: Baseline characteristics and clinical as well as paraclinical information of 780 patients undergoing diagnostic and therapeutic ERCP at Taleghani hospital in Tehran between 2008 and 2012 were reviewed. Data were collected prior to the ERCP, at the time of the procedure, and 24-72 hours after discharge. PEP was diagnosed according to consensus criteria.

Results: Of the 780 patients who underwent diagnostic ERCP, pancreatitis developed in 26 patients (3.3%). In the multivariable risk model, significant risk factors with adjusted odds ratios (ORs) were age <65 years (OR = 10.647, P = 0.023) and erythrocyte sedimentation rate (ESR) >30 (OR = 6.414, P < 0.001). Female gender, history of recurrent pancreatitis, pre-ERCP hyperamylasemia, and difficult or failed cannulation could not predict PEP. There was no significant difference in the rate of PEP in wire-guided cannulation versus biliary cannulation using a sphincterotome and contrast injection as the conventional method.

Conclusions: Performing ERCP may be safer in the elderly. Patients with high ESR may be at greater risk of PEP, which warrants close observation of these patients for signs of pancreatitis after ERCP.

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ESR对预测ercp后胰腺炎重要吗?
背景:胰腺炎仍然是内镜逆行胰胆管造影(ERCP)最常见的并发症,导致大量的发病率和偶尔的死亡率。关于ercp后胰腺炎(PEP)危险因素的报道存在显著的争议和矛盾。目的:评估潜在的危险因素PEP在转诊三级中心,作为伊朗人口的样本。材料和方法:回顾了2008年至2012年在德黑兰Taleghani医院接受诊断和治疗性ERCP的780例患者的基线特征和临床及临床旁信息。数据收集于ERCP术前、手术时和出院后24-72小时。根据共识标准诊断PEP。结果:在接受ERCP诊断的780例患者中,26例(3.3%)发生了胰腺炎。在多变量风险模型中,具有校正优势比(OR)的显著危险因素为30岁(OR = 6.414, P < 0.001)。女性、胰腺炎复发史、ercp前期高淀粉酶血症、插管困难或失败均不能预测PEP。与传统的括约肌切开术和造影剂注射胆道插管相比,钢丝引导插管的PEP率无显著差异。结论:老年人行ERCP可能更安全。高ESR的患者可能有更大的PEP风险,因此需要密切观察这些患者ERCP后是否有胰腺炎的迹象。
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来源期刊
Clinical Medicine Insights. Gastroenterology
Clinical Medicine Insights. Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
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