Analysis Of Factors And Predictive Model For The Development Of Pancreatitis In Patients With Early Hyperamylasemia After ERCP

Objective : To analyze the risk factors of postoperative pancreatitis(PEP)in patients with early hyperamylasemia after endoscopic retrograde cholangiopancreatography(ERCP),to draw a nomogram,to verify the fit of the Hosmer-Lemeshow model,and to evaluate the reliability of the ROC curve.These analytical methods and results can guide patients with hyperamylasemia early after ERCP to get targeted clinical treatment as early as possible,thus preventing further progression of pancreatitis.Methods : Retrospectively analyze the clinical data of 312 patients with early postoperative hyperamylasemia who accepted ERCP surgery in Jiaxing First Hospital from January 2018 to December 2021,of which 107 patients had developed to pancreatitis.Collect these patients,detailed data by Excel tables.Use single factor analysis and logistic multiple regression models to analyze the risk factors for PEP in patients with early hyperamylasemia after ERCP,and plot independent risk factors as a nomograph.Results Univariate analysis showed that female,age below 60 years,stenosis of inferior common bile duct,difficult biliary cannulation,absence of pancreatic duct stent,surgical time over or equal to 1 hour,first ERCP and total bilirubin were significantly associated with the progression to PEP in patients with early hyperamylasemia after ERCP(P<0.05).Logistic regression analysis showed that female,age below 60 years,stenosis of inferior common bile duct,difficult biliary cannulation,absence of pancreatic duct stent,and surgical time over or equal to 1 hour were independent risk factors for progression to PEP in patients with early hyperamylasemia after ERCP.The nomogram used to predict the risk of PEP was drawn according to the multivariate results.The model fit was proved by Hosmer-Lemeshow goodness of fit test,and the area under the ROC curve(AUC = 0.834)confirmed that the model has good predictive ability.Conclusion : Patients with early hyperamylasemia after ERCP who are female,age below 60 years,stenosis of inferior common bile duct,difficult biliary cannulation,absence of pancreatic duct stent,and surgical time over or equal to 1 hour were more likely to suffer from PEP.Based on multifactorial results,the nomogram prediction model was established and validated.The model has good predictive ability and may be applied in the future to clinically guide the treatment of patients with early hyperamylasemia after ERCP,in order to reduce the occurrence of PEP.