Analysis Of Causes And Prognosis For Severe Acute Pancreatitis After ERCP

Objective Retrospective study of the causes and prognosis of severe acute pancreatitis(SAP)after endoscopic retrograde Cholangiopancreatography(ERCP)in our hospital for nearly 10 years,and to provide theoretical support for the prevention and treatment of Post-ERCP pancreatitis(PEP)develop to severe acute pancreatitis.Methods To collect clinical data of101 hospitalized patients with pancreatitis after ERCP from July 2007 to March 2018.According to the classification criteria of pancreatitis after ERCP,the patients were divided into mild to moderate pancreatitis group and severe acute pancreatitis group.The gender,age,smoking history,history of hypertension,history of pancreatitis,history of cholecystectomy,diameter of common bile duct,parapapillary diverticulum,preoperative liver function(AST,ALT,GGT,TBIL),endoscopic sphincterotomy(EST),endoscopic papillary balloon dilation(EPBD),difficulty of intubation,transpapillary biopsies,endoscopic nasobiliary drainage(ENBD),abdominal pain within 3 hours after operation,failure of intubation and pre-incision were analyzed by univariate analysis.The results of single factor analysis were statistically significant,the factors of difference(P < 0.05)were analyzed by logistic regression with two classifications and multiple factors,finally obtain the risk factors of severe acute pancreatitis(SAP).Results Among 101 PEP patients,89 were mild to moderate pancreatitis,12 were severe acute pancreatitis.Univariate analysis showed that normal ALT before operation,normal GGT before operation,difficulty of intubation,abdominal pain within 3 hours after operation and failure of intubation were related to severe acute pancreatitis after ERCP(P <0.05).Multivariate logistic regression analysis showed that normal ALT before operation(OR=17.034),difficulty of intubation(OR=64.574),and abdominal pain within 3 hours after ERCP(OR=28.737)are independent risk factors for severe acute pancreatitis.Conclusions(1)Normal preoperative ALT,normal GGT,difficulty of intubation,abdominal pain within 3hours after ERCP and failure of intubation are related to the occurrence of severe acute pancreatitis;(2)Normal preoperative ALT,difficulty of intubation and abdominal pain within3 hours after ERCP are risk factors for severe acute pancreatitis;(3)Early identify risk factors of SAP have great significance for reducing the occurrence of SAP,medical costs,patients’ pain and mortality.