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Risk Factors of Post-ERCP Pancreatitis at a Tertiary Referral Center in Japan

Kakutani, Hiroshi MD, PhD*; Hino, Syoryoku MD, PhD; Ikeda, Keiichi MD, PhD*; Koyama, Seita MD, PhD*; Mori, Naoki MD, PhD*; Imazu, Hiroo MD, PhD*; Kawamura, Muneo MD, PhD*; Tajiri, Hisao MD, PhD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2014 - Volume 24 - Issue 3 - p 270–273
doi: 10.1097/SLE.0b013e3182901461
Original Articles

Purpose: Endoscopic retrograde cholangiopancreatography (ERCP) has played a major role in the diagnosis of biliary and pancreatic diseases. The prevalence and mortality rate of post-ERCP pancreatitis (PEP) remains a serious issue that needs to be resolved. Here, we report the first ERCP study that was conducted at a high-volume center of an educational institution in Japan.

Methods: This study investigated patients with suspected biliary and pancreatic diseases who had undergone ERCP between April 2006 and June 2009. We created a database and analyzed preoperative and postoperative data. Patients who had undergone surgery and those with a history of undergoing duodenal papilla treatment were excluded.

Results: Mild (n=62) or moderate (n=3) pancreatitis was present in 65 cases (6.21%; 36 men and 29 women). A univariate analysis identified age under 50 years (P=0.01), pancreatography (P<0.001), and biliary stent placement (P<0.001). A Multivariate analysis was performed for evaluating the risk factors associated with PEP. This analysis identified age of the patients under 50 years [P=0.003; odds ratio (OR), 0.37; 95% confidence interval (CI), 0.19-0.71], endoscopic papillary balloon dilation (P=0.012; OR, 4.69; 95% CI, 1.41-15.54), pancreatography (P<0.001; OR, 5.55; 95% CI, 2.98-10.33), and plastic stent placement (P<0.001; OR, 3.77; 95% CI, 2.17-6.54). Descriptive statistics showed that only pancreatography was associated with PEP. An additional sphincterotomy did not increase the risk of PEP (P=0.306; OR, 2.03; 95% CI, 0.52-7.84), and even adjusted for pancreatography.

Conclusions: We changed the size of the stent to 7-Fr. In the future, we plan to repeat the same study with a higher number of cases.

Departments of *Endoscopy, The Jikei University School of Medicine

Internal Medicine, Division of Hepatology and Gastroenterology, The Jikei University School of Medicine, Tokyo

Department of Neuropsychiatry, Takamatsu Hospital, Kanazawa, Japan

The authors declare no conflicts of interest.

Reprints: Hiroshi Kakutani, MD, PhD, Department of Endoscopy, The Jikei University School of Medicine, 105-8471 Minatoku, Nishishinbashi 3-25-8, 105-8461 Tokyo, Japan (e-mail:

Received September 9, 2012

Accepted March 1, 2013

© 2014 by Lippincott Williams & Wilkins