Korean J Gastrointest Endosc > Volume 37(4); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;37(4): 265-270.
Nafamostat Mesilate 전처치를 시행한 환자에서의 내시경역행담췌관조영술 후 급성췌장염의 위험인자
김일두ㆍ강대환ㆍ박진현ㆍ배정호ㆍ김표준ㆍ김용욱ㆍ최철웅ㆍ엄재섭ㆍ이선미ㆍ김태오ㆍ김광하ㆍ송근암
부산대학교 의학전문대학원 내과학교실
Risk Factors for Post-ERCP Pancreatitis in Patients Pretreated with Nafamostat Mesilate
Il Doo Kim, M.D., Dae Hwan Kang, M.D., Jin Hyun Park, M.D., Jung Ho Bae, M.D., Pyo Jun Kim, M.D., Yong Wook Kim, M.D., Cheol Woong Choi, M.D., Jae Sup Eum, M.D., Sun Mi Lee, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D. and Geun Am Song, M.D.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
Abstract
Backgound/Aims: Pancreatitis is the most common and important complication of an endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to identify risk factors for post ERCP-pancreatitis in patients pretreated with nafamostat mesilate, a synthetic protease inhibitor.
Methods:
A total of 247 patients who underwent an ERCP were evaluated prospectively. Potential risk factors of post-ERCP pancreatitis in patients pretreated with nafamostat mesilate were evaluated.
Results:
Twenty-four patients (9.7%) and nine patients (3.6%) developed post-ERCP hyperamylasemia and pancreatitis, respectively. As determined by univariate analysis among the potential risk factors, we found a procedure time over 20 minutes, pancreatic duct cannulation over four times, prior post-ERCP pancreatitis and the absence of a common bile duct (CBD) stone as risk factors for post-ERCP hyperamylasemia. We also found a patient age under 60 years, a procedure time over 20 minutes, pancreatic duct cannulation over four times and the absence of a CBD stone as risk factors for post-ERCP pancreatitis (p<0.05). As determined by multivariate analysis, pancreatic cannulation over four times is independently associated with post-ERCP hyperamylasemia (p=0.038; OR, 5.165; 95% CI, 1.093∼24.412) and post-ERCP pancreatitis (p=0.002; OR, 33.122; 95% CI, 3.526∼311.138).
Conclusions:
A repeated pancreatic duct cannulation is the most important risk factor for post-ERCP pancreatitis in patients pretreated with nafamostat mesilate. (Korean J Gastrointest Endosc 2008; 37:265-270)
Key Words: Post-ERCP pancreatitis, Risk factors, Prevention, Nafamostat mesilate
주요어: 내시경역행담췌관조영술, 급성 췌장염, 위험인자, 예방, Nafamostat mesilate
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