Predisposing Factors in Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Authors

  • Gotam Das Resident of gastroenterology, Isra University Hospital Hyderabad
  • Prem Kumar Assistant Professor of gastroenterology, Isra University Hospital Hyderabad
  • Muhammad Akram Bajwa Associate Professor of gastroenterology, LUMHS/Jamshoro
  • Sajan Sawai Assistant Professor of gastroenterology, Indus Medical College TM Khan
  • Muneer Sadiq Assistant Professor of medicine, Altibri Medical college Karachi
  • Shabnam Rani Assistant Professor of medicine, MMC Mirpurkhas

Keywords:

Mortality, peritonitis, complications, cause, sepsis.

Abstract

Objective: To determine the frequency of predisposing factors in post endoscopic retrograde cholangiopancreatography pancreatitis at Isra university hospital Hyderabad

Material And Methods: The Descriptive cases series study was conducted in the department of gastroenterology at Isra University Hospital, Hyderabad from September 2018 to 10 March 2019.

All the patients aged 18 to 50 years, both genders and diagnosed as case of post ERCP pancreatitis were included. All the patients were undergoing ERCP procedure. Procedure was done under conscious sedation or propofol where needed. Antibiotic prophylaxis 1gm intravenous will be used. All patients were discharged after 5 hours; if there will be no any complications. Serum amylase level was assessed in all patients at 4 hours. Patients diagnosed as a case of post ERCP pancreatitis on the basis of new onset or worsening of abdominal pain and elevated serum amylase level three times the upper normal limit were further studies. After the selection of the cases, patients will be evaluated for the presence or absence of contributing factors like age, gender, cannulation attempts, cannulation time, precut papillotomy, pancreatic duct contrast injection, previous history of post ERCP pancreatitis and sphincter of Oddi dysfunction. All the data will be recorded in the proforma. The data was entered and analyzed in statistical program SPSS version 26.0.

Results:  Mean age of the patients was 42.7 years. Majority of the patients 65.47%  were males and 32.90% were females. Mean duration of pancreatitis was 3.1 days. Sphincter of oddi dysfunction was in 17.1% 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 of effect modifiers on predisposing factors in post endoscopic retrograde cholangiopancreatography pancreatitis, p-values were almost insignificant.

Conclusion: It was concluded that frequency of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was found not very high in our practice and in agreement with other studies. Female gender, pre-cut papillotomy and repeated pancreatic duct injection were the most important risk factors associated with/ contributing to the development of post ERCP acute pancreatitis

Key words: PERCP, predisposing factors

Published

2022-06-22

Issue

Section

Original Articles