Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases
Abstract Background To investigate the risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary tract diseases. Methods We retrospectively analyzed the clinical data of 480 patients who underwent ERCP for biliary tract diseases at the Affiliat...
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BMC
2023-03-01
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Online Access: | https://doi.org/10.1186/s12893-023-01953-4 |
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author | Jin-yuan Chi Lin-ya Ma Jia-cheng Zou Yue-feng Ma |
author_facet | Jin-yuan Chi Lin-ya Ma Jia-cheng Zou Yue-feng Ma |
author_sort | Jin-yuan Chi |
collection | DOAJ |
description | Abstract Background To investigate the risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary tract diseases. Methods We retrospectively analyzed the clinical data of 480 patients who underwent ERCP for biliary tract diseases at the Affiliated Zhongshan Hospital of Dalian University from October 2011 to October 2016. The patients were divided into a study group (n = 75, with PEP) and a control group (n = 405, without PEP) based on whether they developed post-ERCP pancreatitis (PEP), and their clinical baseline data and intraoperative conditions were retrieved and compared. Then, factors associated with PEP were analyzed using logistic regression model, based on which a nomogram prediction model was constructed. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the performance of the prediction model. Results Significant differences in age, sex, history of pancreatitis, history of choledocholithiasis, pancreatic duct imaging, pancreatic sphincterotomy, difficult cannulation, multiple cannulation attempts and juxtapapillary duodenal diverticula were observed between the two groups. Multivariate logistic regression analysis showed that age less than 60 years (OR, 0.477; 95% CI, 0.26–0.855), female sex (OR, 2.162; 95% CI, 1.220–3.831), history of pancreatitis (OR, 2.567; 95% CI, 1.218–5.410), history of choledocholithiasis (OR, 2.062; 95% CI, 1.162–3.658), pancreatic sphincterotomy (OR, 2.387; 95% CI, 1.298–4.390), pancreatic duct imaging (OR, 4.429; 95% CI, 1.481–13.242), multiple cannulation attempts (OR, 2.327; 95% CI, 1.205–4.493), difficult cannulation (OR, 2.421; 95% CI, 1.143–5.128), and JPD (OR, 2.002; 95% CI, 1.125–3.564) were independent risk factors for PEP. The nomogram for predicting the occurrence of PEP demonstrated an area under the ROC curve (AUC) of 0.787, and the calibration curves of the model showed good consistency between the predicted and actual probability of PEP. Conclusion Our results showed that age less than 60 years, female sex, history of pancreatitis, history of choledocholithiasis, pancreatic sphincterotomy, pancreatic duct imaging, multiple cannulation attempts, difficult cannulation and juxtapapillary duodenal diverticula were independent risk factors for PEP. In addition, the established nomogram demonstrated promising clinical efficacy in predicting PEP risk in patients who underwent ERCP for biliary tract diseases. |
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spelling | doaj.art-a9562abaf16b45afaf147bbc5fad11a02023-03-26T11:05:46ZengBMCBMC Surgery1471-24822023-03-012311910.1186/s12893-023-01953-4Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseasesJin-yuan Chi0Lin-ya Ma1Jia-cheng Zou2Yue-feng Ma3Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian UniversityDepartment of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian UniversityAbstract Background To investigate the risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary tract diseases. Methods We retrospectively analyzed the clinical data of 480 patients who underwent ERCP for biliary tract diseases at the Affiliated Zhongshan Hospital of Dalian University from October 2011 to October 2016. The patients were divided into a study group (n = 75, with PEP) and a control group (n = 405, without PEP) based on whether they developed post-ERCP pancreatitis (PEP), and their clinical baseline data and intraoperative conditions were retrieved and compared. Then, factors associated with PEP were analyzed using logistic regression model, based on which a nomogram prediction model was constructed. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the performance of the prediction model. Results Significant differences in age, sex, history of pancreatitis, history of choledocholithiasis, pancreatic duct imaging, pancreatic sphincterotomy, difficult cannulation, multiple cannulation attempts and juxtapapillary duodenal diverticula were observed between the two groups. Multivariate logistic regression analysis showed that age less than 60 years (OR, 0.477; 95% CI, 0.26–0.855), female sex (OR, 2.162; 95% CI, 1.220–3.831), history of pancreatitis (OR, 2.567; 95% CI, 1.218–5.410), history of choledocholithiasis (OR, 2.062; 95% CI, 1.162–3.658), pancreatic sphincterotomy (OR, 2.387; 95% CI, 1.298–4.390), pancreatic duct imaging (OR, 4.429; 95% CI, 1.481–13.242), multiple cannulation attempts (OR, 2.327; 95% CI, 1.205–4.493), difficult cannulation (OR, 2.421; 95% CI, 1.143–5.128), and JPD (OR, 2.002; 95% CI, 1.125–3.564) were independent risk factors for PEP. The nomogram for predicting the occurrence of PEP demonstrated an area under the ROC curve (AUC) of 0.787, and the calibration curves of the model showed good consistency between the predicted and actual probability of PEP. Conclusion Our results showed that age less than 60 years, female sex, history of pancreatitis, history of choledocholithiasis, pancreatic sphincterotomy, pancreatic duct imaging, multiple cannulation attempts, difficult cannulation and juxtapapillary duodenal diverticula were independent risk factors for PEP. In addition, the established nomogram demonstrated promising clinical efficacy in predicting PEP risk in patients who underwent ERCP for biliary tract diseases.https://doi.org/10.1186/s12893-023-01953-4Biliary tract diseaseEndoscopic retrograde cholangiopancreatographyRisk factorsPostoperative pancreatitis |
spellingShingle | Jin-yuan Chi Lin-ya Ma Jia-cheng Zou Yue-feng Ma Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases BMC Surgery Biliary tract disease Endoscopic retrograde cholangiopancreatography Risk factors Postoperative pancreatitis |
title | Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
title_full | Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
title_fullStr | Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
title_full_unstemmed | Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
title_short | Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
title_sort | risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases |
topic | Biliary tract disease Endoscopic retrograde cholangiopancreatography Risk factors Postoperative pancreatitis |
url | https://doi.org/10.1186/s12893-023-01953-4 |
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