Korean Journal of Gastrointestinal Endoscopy 2006;32(4): 266-270.
침형 절개도를 이용한 유두 예비절개술 후 발생되는 급성 췌장염 발생에 있어서의 위험 인자 분석
이준규·박주경·이상협·윤원재·이광혁·류지곤·김용태·윤용범
서울대학교 의과대학 내과학교실, 간연구소
Risk Factors for Post-ERCP Pancreatitis after Needle Knife Sphincterotomy following Repeated Probing
Jun Kyu Lee, M.D., Joo Kyoung Park, M.D., Sang Hyub Lee, M.D., Won Jae Yoon, M.D., Kwang Hyuck Lee, M.D., Ji Kon Ryu, M.D., Yong-Tae Kim, M.D. and Yong Bum Yoon, M.D.
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
Abstract
Background/Aims: Needle knife sphincterotomy (NKS) following repeated probing due to difficult cannulation during ERCP increase the risk of post-ERCP pancreatitis. However, the risk factors for post-ERCP pancreatitis are not well-known. The aim of this study is to investigate the incidence and risk factors of post-ERCP pancreatitis in patients who underwent NKS. We also evaluated the effect of gabexate on the prevention of post-ERCP pancreatitis. Methods: Medical records from a total of 200 patients who underwent NKS following repeated probing during ERCP were reviewed retrospectively. The potential risk factors for post-ERCP pancreatitis were investigated. The effect of gabexate infusion after ERCP procedure on the incidence of post-ERCP pancreatitis was also evaluated. Results: A total of 13 (6.5%) patients out of 200 patients developed post-ERCP pancreatitis. Gender, age, the presence of pancreatitis at procedure, underlyng disease, direction of sphincterotomy, success or failure of cannulation, diameter of CBD, pancreatic duct status and the presence of acinar filling were proved unrelated with pancreatitis. Post-ERCP pancreatitis developed in 9 out of 38 (23.7%) when gabexate was given, while 4 out of 160 (2.5%) experienced pancreatitis without administration of gabexate. Conclusions: We couldn't determine any risk factor for pancreatitis in patients who underwent NKS following repeated probing during ERCP. The gabexate infusion after ERCP procedure might be associated with the increased risk of pancreatitis. (Korean J Gastrointest Endosc 2006;32:266270)
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