title: Frequency and risk factors in the post-ERCP pancreatitis in a tertiary care centre.
abstract: OBJECTIVE
  To evaluate the frequency and associated factors in the post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
  
  
  METHODS
  Cross-sectional analytical study.
  
  
  METHODS
  Endoscopy Suite of Surgical Unit IV, Civil Hospital, Karachi, from December 2009 to November 2010.
  
  
  METHODS
  Patients undergoing ERCP were included. Patients who had presented with pancreatitis or raised amylase levels before procedure or patients who had previous history of surgery on the biliary or pancreatic systems were excluded from the study. Pearson chi-square and Fisher's exact test were used for qualitative data and t-test for quantitative data. Significance was taken as p ² 0.05. Odds ratio was calculated for the qualitative data using 95% confidence interval.
  
  
  RESULTS
  Age of the study population ranged from 9 to 90 years (mean age 46.5 ± 14.94 years, median 45 years). Male to female ratio was 1:1.87. Pancreatitis was seen in 18 patients (3.6%), mild in 15 (3%), moderate in one (0.2%) and severe in 2 (0.4%). Mean amylase level at 4 hours and 24 hours was 280.93 ± 539.13 and 168.83 ± 338.34 respectively. Pancreatitis was seen in 15/326 (4.6%) females and 3/174 (1.72%) males. Statistically significant increased risk for pancreatitis was seen in difficult cannulation (9.8%, p = 0.006), prolonged cannulation time (7.6 minute, p = 0.002), pancreatic duct cannulation (13.7%, p = 0.001) and pancreatic duct contrast injection (13.4%, p < 0.001).
  
  
  CONCLUSIONS
  The frequency of post-ERCP pancreatitis was 3.6%. Difficult cannulation, pancreatic duct cannulation, pancreatic duct contrast injection and balloon sphincteroplasty were associated with higher frequency of post-ERCP pancreatitis. Reuse of ERCP accessories poses no additional risk to the frequency of pancreatitis.
authors.affiliation: Department of Surgery, Civil Hospital, Karachi.
authors.forename: Aftab
authors.initials: A
authors.lastname: Leghari
authors.forename: Shahriyar
authors.initials: S
authors.lastname: Ghazanfar
authors.forename: Sajida
authors.initials: S
authors.lastname: Qureshi
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Taj
authors.forename: Saad Khalid
authors.initials: SK
authors.lastname: Niaz
authors.forename: M Saeed
authors.initials: MS
authors.lastname: Quraishy
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic; D013997:Time Factors; D055815:Young Adult
chemical_list: D000681:Amylases