Predictors of post-ERCP complications in patients with suspected choledocholithiasis

被引:104
作者
Mehta, SN
Pavone, E
Barkun, JS
Bouchard, S
Barkun, AN
机构
[1] McGill Univ, Montreal Gen Hosp, Div Gastroenterol, Montreal, PQ H3G 1A4, Canada
[2] McGill Univ, Montreal Gen Hosp, Div Gen Surg, Montreal, PQ H3G 1A4, Canada
[3] McGill Univ, Montreal Gen Hosp, Div Clin Epidemiol, Montreal, PQ H3G 1A4, Canada
[4] McGill Univ, Royal Victoria Hosp, Montreal, PQ H3A 1A1, Canada
关键词
D O I
10.1055/s-2007-1001308
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Study Aims: Determinants of complications after endoscopic retrograde cholangiopancreatography (ERCP) have not yet been completely characterized, Patients and Methods: Data were collected from an endoscopic database. Univariate analysis and multivariate logistic regression analysis were used to generate the best model of independent predictors of post-ERCP pancreatitis, Results: The database included 1239 ERCP examinations carried out to investigate suspected choledocholithiasis over a five-year period. From these, 45 patients who developed post-ERCP complications were compared to a random sample of 486 patients who had undergone an uncomplicated ERCP for suspected choledocholithiasis, Univariate analysis demonstrated significant differences between the two patient groups for the following factors: age, using a cut-off point of 59 years (27% vs. 51%, P = 0.002), pancreatic channel opacification (73% vs. 58%, P = 0.05), and absence of common bile duct stones (41% vs. 24%, P = 0.03), Using multivariate logistic regression, the best model for predicting post-ERCP pancreatitis in patients undergoing sphincterotomy included age under 59 years (P = 0.04), and absence of a common bile duct stone (P = 0.004), The model yielded probabilities of developing post-sphincterotomy pancreatitis that ranged from 2.8% if no predictor was present, to 27% when both predictors were present. Among patients in whom a sphincterotomy was not performed, the only significant independent predictor found was pancreatic channel opacification (P = 0,05), Conclusion: Age under 59 years, pancreatic channel opacification, and an absence of common bile duct stones at ERCP are all independent predictors of post-ERCP pancreatitis.
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收藏
页码:457 / 463
页数:7
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