Risk Factors Of Acute Pancreatitis After ERCP In Elderly Patients

Objective :To investigate the risk factors of acute pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients.Methods:The complete data of 736 patients over 70 years old who underwent ERCP in our endoscopy center from 2012 to 2020 were retrospectively analyzed.The related factors(gender,hypertension history,previous PEP history,gallstones,common bile duct diameter,preoperative ALT,etc.)were analyzed.Intraoperative operation related factors(common bile duct diameter,guide wire into pancreatic duct many times,pancreatic duct development,parapapillary diverticulum,difficult intubation,etc.);The risk factors for postoperative PEP in elderly patients were obtained.Results:In this study,a total of 72 patients with postoperative pancreatitis were enrolled,including 63 cases of mild to moderate pancreatitis and 9 cases of severe acute pancreatitis.Single factor analysis showed that gender(P < 0.001),previous history of PEP(P = 0.006),normal preoperative ALT(P = 0.003),multiple entry of the guide wire into the pancreatic duct(P = 0.015),pancreatic duct development(P =0.033),difficulty in intubation(P = 0.007),and parapapillary diverticulum(P =0.003)were related to concurrent acute pancreatitis(P < 0.05).Multivariate analysis showed that Gender(female),previous PEP history,preoperative ALT normal,guide wire into the pancreatic duct many times,peripapillary diverticulum,difficult intubation was an independent risk factor for acute pancreatitis in elderly patients after ERCP.Conclusion:1.Gender(female),previous PEP history,preoperative ALT normal,guide wire into the pancreatic duct many times,peripapillary diverticulum,difficult intubation are independent risk factors for acute pancreatitis in elderly patients after ERCP;2.Early identification of SAP risk factors,take the necessary preventive measures,can reduce the mortality of elderly patients,reduce the suffering of patients,reduce hospitalization costs,to improve the survival rate of patients is of great significance.