Iatrogenic pancreatitis in patients with IPMN after ERCP: incidence and predictive signs.
OBJECTIVE
The prevalence of intraductal papillary mucinous neoplasm (IPMN) has recently increased, and endoscopic retrograde cholangiopancreatography (ERCP) is a major diagnostic modality for IPMN. The aim of our study was to determine the prevalence rate of iatrogenic pancreatitis in the patients with IPMN and the predictive signs on pre-procedural images and endoscopic procedures.


METHODS
At a single center, patients who underwent ERCP between September 2001 and December 2010 were included in this study. The presence of iatrogenic pancreatitis was evaluated and the difference of prevalence in the patients with/without IPMN was determined. Then, a review of cross-sectional images was performed.


RESULTS
The prevalence rate of iatrogenic pancreatitis in the patients with IPMN was 20% and that in the patients with other pancreatic cystic lesions was 14%. Mural nodules on images and filling defects on ERCP were more highly detected in the patients without iatrogenic pancreatitis (p = 0.040 and p = 0.027, respectively). In the multivariate analysis, the presence of filling defects correlated with a decreased incidence of iatrogenic pancreatitis (odds ratio = 0.119 and p = 0.047).


CONCLUSIONS
In this study, the prevalence rate of ERCP-induced pancreatitis in the patients with IPMN was 21%, and the presence of filling defects was associated with a decreased incidence of iatrogenic pancreatitis.
Department of Internal Medicine, Kyungpook National University School of Medicine, 101, 2-Ga, Dongin-Dong, Jung-Gu, Daegu, 700-422, South Korea, minky1973@kornet.net.
Min Kyu
MK
Jung
Yun-Jin
YJ
Jang
Chang Min
CM
Cho
Gab Chul
GC
Kim
Seung Hyun
SH
Cho
Dakeun
D
Lee
Hun Kyu
HK
Ryeom
Kyung Min
KM
Shin
D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence