STUDY OF RISK FACTORS FOR ACUTE POST ENDOSCOPIC RETROGRADE COLANGIOPANCREATOGRAPHY ERCP PANCREATITIS

*Hasan Esmaiel Student of Master (MD) and Hassan Zaizafon (Professor)

ABSTRACT

Background: Post ERCP pancreatitis(PEP) is considered the most complication of ERCP, associated with significant morbidity and occasionally mortality. It is considered of great clinical significance to identify the risk factors for PEP to improve final outcome. Objective: The aim of the current study was to determine risk factors that contribute to the development of PEP and identify the high-risk patients. Patients and Methods: An analytic study (cross-sectional) included all patients older than 16 years who referred to the department of Gastroenterology in Lattakia Hospital during the period one year(2023-2024) who underwent ERCP for various indications. Results: A total of 180 patients, 74 males (41.1%) and 106 females (58.9%) with mean age 55.82±5.2 years were included in the study. Therapeutic interventions represented the most frequent indication for ERCP (88.3%) and the overall incidence of PEP was 8.3%. Acute onset of abdominal pain was reordered in all patients who developed PEP with more than three times of normal value of amylase, p<0.05. Independent risk factors for development of PEP were female gender(p:0.04), younger patients(p:0.002), diagnostic indications for ERCP(p:0.003), normal levels of direct bilirubin(p:0.0001), pancreatic duct cannulation(p:0.0001), injection of contrast material into pancreatic duct with higher volumes of the material(p:0.0001), longer duration of procedure (p:0.0001), previous history of PEP(p:0.01), and higher body mass index BMI (p:0.0001).
Conclusion: The incidence of PEP is high in the current study, more common in presence of certain risk factors related to patient and ERCP technique, so it is crucial to select patients carefully with applying of appropriate technique to reduce associated morbidity.

Keywords: Acute, ERCP, pancreatitis, Lattakia, morbidity.