Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years

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• 作者：Jian-Jun Chen (1) (2)
  Xi-Mo Wang (1) (2)
  Xing-Qiang Liu (2)
  Wen Li (2)
  Mo Dong (2)
  Zong-Wu Suo (2)
  Po Ding (2)
  Yue Li (2)
  
  1. Department of Gastroenterology ; Tianjin Nankai Hospital ; No.6 Changjiang Road ; Nankai District ; Tianjin ; 300100 ; China
  2. Department of Gastroenterology ; People鈥檚 Hospital of Tianjin ; Jieyuan Road 190 ; Tianjin ; 300121 ; China
  
• 关键词：Endoscopic retrograde cholangiopancreatography ; Pancreatitis ; Risk factors ; Systematic review
• 刊名：European Journal of Medical Research
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：19
• 期：1
• 全文大小：565 KB
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• 刊物主题：Medicine/Public Health, general;
• 出版者：BioMed Central
• ISSN：2047-783X

文摘

Background Post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common and most severe complication associated with diagnostic and therapeutic ERCP. A multivariate analysis of risk factors for PEP is essential for identifying patients at high risk and subsequently choosing other suitable diagnoses. Methods Pertinent publications were identified through systematic searches of MEDLINE, Elsevier, and Springer; we performed a systematic review of 12 clinical studies published in the past ten years, selected out of 451 reviewed articles, in which risk factors for pancreatitis were identified. Seven probable risk factors were evaluated, and outcomes expressed in the case of dichotomous variables, as an odds ratio (OR) (with a 95% confidence interval, 95% CI). Results When the risk factors were analyzed, the OR for female gender was 1.40 (95% CI 1.24 to 1.58); the OR for previous PEP was 3.23 (95% CI 2.48 to 4.22); the OR for previous pancreatitis was 2.00 (95% CI 1.72 to 2.33); the OR for endoscopic sphincterotomy was 1.42 (95% CI 1.14 to 1.78); the OR for precut sphincterotomy was 2.11 (95% CI 1.72 to 2.59); the OR for Sphincter of Oddi dysfunction was 4.37 (95% CI 3.75 to 5.09); and the OR for non-prophylactic pancreatic duct stent was 2.10 (95% CI 1.63 to 2.69). Conclusions It appears that female gender, previous PEP, previous pancreatitis, endoscopic sphincterotomy, precut sphincterotomy, Sphincter of Oddi dysfunction, and non-prophylactic pancreatic duct stent are the risk factors for post-ERCP pancreatitis.