Predisposing Factors in Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Abstract

Objective: To ascertain the prevalence of risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography at Isra University Hospital in Hyderabad.

Methodology: This descriptive case series study was done at the gastroenterology department of Isra University Hospital, Hyderabad, from September 2018 to March 2020. Patients aged 18 to 50 years, both genders, and diagnosed with post-ERCP pancreatitis were included. All the patients were undergoing an ERCP procedure. The procedure was done under conscious sedation or propofol where needed. The serum amylase level was assessed in all patients at 4 hours. Patients had been considered to have post-ERCP pancreatitis if they developed new or worsening pain of abdomen and had a threefold increase in serum amylase. All the cases were assessed regarding risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography. All the data was recorded in the proforma.

Results: The mean age of the patients was 42.7 years. The majority of the patients (65.47%) were females and 32.90% were males. The mean duration of pancreatitis was 3.1 days. Sphincter of Oddi dysfunction was found in 17.1% of cases. Precut papillotomy was done in 18(23.7%) cases. Repeated pancreatic duct injury was seen in 10(13.2%) cases. No significant difference was found in the effect of modifiers on predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis, p-values were almost insignificant.

Conclusion: Cannulation attempts, Sphincter of Oddi dysfunction, precut papillotomy, repeated pancreatic duct injection, and female gender were observed to be the predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis.