Risk factors for post-ERCP cholangitis in patients with pancreatic cancer from a single referral center in Iran.
Cholangitis is relatively uncommon but associated mortality is high due to the predisposition in people with underlying disease. For this recognition of contributing risk factors is necessary. Therefore, the present descriptive- analytical cross-sectional survey was designed to determine contributing risk factors for post-ERCP cholangitis in patients with pancreatic cancer. From 2005 to 2010, 110 consecutive cases of pancreatic cancer attending to a tertiary referral centre (Taleghani Hospital), Tehran, Iran were recruited. The patients all underwent stenting via endoscopic retrograde cholangiopancreatography (ERCP). On univariate analysis, a metallic stent type (95% confidence interval (CI) 1.025-11.34, P=0.037), having no jaundice (1.44-2.22, P=0.009), having no pain (1.32-1.91, P=0.026), a history of prior ERCP (1.16-10.37, P=0.020), and having a proximal biliary stone (1.002- 5.93, P=0.046) were related to cholangitis. However on multivariate analysis, none of these factors were found to be contributing risk factors. Cholangitis is avoidable with adequate biliary drainage. Because success rates are higher and complication rates lower for endoscopists performing large volumes of ERCP, performance of the procedure should be concentrated as much as possible in institutions with endoscopists having adequate experience. Patients with a high risk for complications may be best served by referral to an advanced center.
Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Babak
B
Salehimarzijarani
Zohreh
Z
Dadvar
Mirhadi
M
Mousavi
Dariush
D
Mirsattari
Mohammad Reza
MR
Zali
Amir Houshang
AH
Mohammad Alizadeh
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002761:Cholangitis / Q000209:etiology*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004322:Drainage; D005260:Female; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000150:complications*; D012307:Risk Factors; D015607:Stents