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Is ESR Important for Predicting Post-ERCP Pancreatitis?

机译:ESR对预测ERCP后胰腺炎重要吗?

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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 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.
机译:背景:胰腺炎仍然是内镜逆行胰胆管造影(ERCP)的最常见并发症,导致大量发病和偶发性死亡。关于ERCP术后胰腺炎(PEP)危险因素的争议和报道相互矛盾。目的:评价在转诊第三中心作为伊朗人口样本的PEP的潜在危险因素。材料和方法:基线特征和本文回顾了2008年至2012年间在德黑兰Taleghani医院接受诊断性和治疗性ERCP的780例患者的临床及辅助临床信息。在ERCP之前,手术时以及出院后24-72小时内收集数据。结果:在接受ERCP诊断的780例患者中,有26例发生了胰腺炎(3.3%)。在多变量风险模型中,具有校正比值比(OR)的重要风险因素为30岁(OR = 6.414,P <0.001)。女性,复发性胰腺炎病史,ERCP前高淀粉血症,插管困难或失败无法预测PEP。与传统的括约肌切开术和造影剂注射相比,线引导套管插管与胆管插管的PEP率无显着差异。结论:ERCP在老年人中可能更安全。高ESR的患者可能有更大的PEP风险,因此有必要密切观察这些患者ERCP后是否有胰腺炎的迹象。

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