Analysis The Risk Factors Of Post-ERCP Pancreatitis And Establishment Of Risk Scoring System

ObjectiveEndoscopic retrograde cholangiopancreatography as an effective diagnosis and treatment technology,because of its small trauma,good efficacy and other advantages have been widely used in the diagnosis and treatment of clinical bile pancreatic diseases,but inevitably,there are still some complications after surgery,including post-ERCP pancreatitis(post-ERCP pancreatitis),PEP)is one of the most common complications of ERCP,according to relevant statistics,the incidence rate can reach 2%-15%,once it occurs will extend the length of hospital stay,increase the cost of hospitalization,and even lead to the death of patients,but it is not clear how PEP occurs,considering a variety of factors;In order to establish a risk scoring system that can predict the occurrence of postoperative pancreatitis,and finally,through this study,to guide clinical targeted prevention,the goal is to reduce the probability of PEP occurring.MethodThis study retrospectively analyzed clinical data on 412 patients with routine ERCP surgery who were treated for hepatocholinical surgery at Dalian Medical University Hospital from January 2017 to December 2019,the patient’s clinical data are collected and collated,the medical history data and surgical related data are analyzed,the relevant risk factors of PEP after ERCP surgery are summarized,and then a risk scoring system that can predict the occurrence of PEP can be established by statistical methods,and finally through this study,the clinical targeted prevention is guided,so as to reduce the occurrence of PEP.ResultAccording to the selected criteria,a total of 412 patients with ERCP surgery were included in the study,and through statistical analysis,the occurrence rate of PEP was10.194%(42/412),and a single-factor analysis was carried out through SPSS 26.00 statistical software.In the past,there is a history of pancreatitis,endoscopic stone,pancreatic tube development,intlection difficulties,operating time≥45 minutes,line ENBD insertion,cholectic tube stent insertion as a risk factor for PEP,and multi-factor analysis results show that women,Pancreatic tube development,intlethion difficulties,operating time≥45min as independent risk factors for acute pancreatitis after surgery,and then the above independent risk factors through Logistic regression analysis,and then the results show the B value of individual risk factors in a rounded manner We learned that the female was 1 point,the residual pancreatic tube development,intring difficulties,operating time≥45min are 2 points,the score range is 0-7 points,and then through this scoring system to the 412 patients in this study in turn score,Then draw the ROC curve,through the ROC curve analysis,calculate the area under the curve is0.856,we then use the Youden’S Index to calculate the score points in the scoring system,to arrive at the best boundary point,and to conclude that the score is 1.5points,the highest Sensitivity and specificity,respectively,0.786 and 0.805,so we can learn that when the score value is less than 1.5 points,the probability of postoperative PEP occurrence is not high,when the score is greater than 1.5 points,the probability of postoperative PEP significantly increased.ConclusionsFemale patients,pancreatic tube development,intring difficulties,operating time≥45min were independent risk factors for acute pancreatitis after surgery.When there is pancreatic tube development,intine difficulties,operating time≥45min any one,both intraoperative and postoperative preventive measures can be applied to reduce the occurrence of PEP.