Endoscopic retrograde cholangiopancreatography-induced acute pancreatitis often has a benign outcome.
BACKGROUND
Acute pancreatitis (AP) is the commonest complication of endoscopic retrograde cholangiopancreatography (ERCP). Data regarding the clinical course and outcome of post-ERCP pancreatitis are sparse, although the available data suggest it to be a severe disease.


OBJECTIVE
To examine the clinical course, disease severity, and outcome of patients with post-ERCP-AP.


METHODS
All consecutive patients with post-ERCP-AP were included. They were managed according to a standard protocol. Outcome measures were severity of pancreatitis, infectious complications, need for surgery and mortality. The clinical course and outcome of patients with post-ERCP-AP were also compared with those of patients with gallstone pancreatitis (GS-AP).


RESULTS
Of the 1497 de novo ERCP procedures, 57 (3.8%) patients developed AP. Their mean age was 40.2 years (13.1), 16 were males of them, 54 (95%) patients had mild pancreatitis. Only 2 patients developed organ failure. Fifty-four (95%) patients recovered with conservative management. One of the 57 patients died. As compared with patients with GS-AP (n=174), APACHE II scores at admission [3.3 (3.1) vs. 5.8 (4.8); P=0.011], occurrence of pancreatic necrosis (17.5% vs. 39.1%; P=0.020), organ failure (3.5% vs. 19.0%; P=0.015), infectious complications (8.7% vs. 24.7%; P=0.040), and mortality (1.8% vs. 13.2%; P=0.044) were significantly less among patients with post-ERCP-AP.


CONCLUSIONS
Unlike previous belief, we found that post-ERCP AP was a mild disease with a favorable outcome in most cases.
Bhatia
Vikram
V
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Garg
Pramod Kumar
PK
Tandon
Rakesh Kumar
RK
Madan
Kaushal
K
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D011379:Prognosis