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Synergistic effect of independent risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis: a multicenter retrospective study in Japan
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Hirokazu Saito, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Masayoshi Uehara, Ikuo Matsushita, Tatsuyuki Kakuma, Shunpei Hashigo, Shuji Tada
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Clin Endosc 2024;57(4):508-514. Published online April 18, 2024
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DOI: https://doi.org/10.5946/ce.2023.203
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 Abstract
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 - Background
/Aims: This study aimed to examine the synergistic effect of independent risk factors on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
Methods
This multicenter retrospective study included 1,273 patients with native papillae who underwent ERCP for bile duct stones in Japan. Independent PEP risk factors were identified using univariate and multivariate analyses. Significant risk factors for PEP in the multivariate analysis were included in the final analysis to examine the synergistic effect of independent risk factors for PEP.
Results
PEP occurred in 45 of 1,273 patients (3.5%). Three factors including difficult cannulation ≥10 minutes, pancreatic injection, and normal serum bilirubin level were included in the final analysis. The incidences of PEP in patients with zero, one, two, and three factors were 0.5% (2/388), 1.9% (9/465), 6.0% (17/285), and 12.6% (17/135), respectively. With increasing risk factors for PEP, the incidence of PEP significantly increased (1 factor vs. 2 factors, p=0.006; 2 factors vs. 3 factors, p=0.033).
Conclusions
As the number of risk factors for PEP increases, the risk of PEP may not be additive; however, it may multiply. Thus, aggressive prophylaxis for PEP is strongly recommended in patients with multiple risk factors.
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Citations
Citations to this article as recorded by  - Risk factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography: a retrospective single-center study
I.М. Mamontov, D.D. Rjabushhenko, Т.І. Tamm, К.О. Kramarenko, V.V. Nepomniashchyi, A.T. Ustinov
Український радіологічний та онкологічний журнал.2024; 32(3): 287. CrossRef
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