title: Risk factors for post-ERCP pancreatitis and hyperamylasemia: A retrospective single-center study.
abstract: OBJECTIVE
  With an increased use of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP complications have attracted much attention. We aimed to identify independent risk factors of post-ERCP pancreatitis (PEP) and hyperamylasemia, and to develop a simple scoring system of the factors contributing to the clinical prevention against PEP.
  
  
  METHODS
  A retrospective single-center analysis was performed in 4234 ERCP procedures between September 2007 and December 2012. Patient-related and procedure-related risk factors for PEP and post-ERCP hyperamylasemia were identified by univariate and multivariate regression analyses. A scoring system was developed based on the independent risk factors.
  
  
  RESULTS
  PEP occurred in 226 (5.3%) ERCP procedures and hyperamylasemia in 774 (18.3%) procedures. Female gender (odds ratio [OR] 1.449), first-time ERCP (OR 1.745), latent jaundice (OR 1.917), difficult cannulation (OR 3.317) and pancreatography (OR 1.823) were all proven to be significant risk factors for predicting PEP. In addition, difficult cannulation (OR 1.990) and pancreatography (OR 2.009), age <60 years (OR 1.294), prior diabetes (OR 0.614), biliary duct stent placement (OR 1.884) and nasobiliary drainage (OR 1.613) were associated with developing hyperamylasemia. Prophylactic pancreatic duct stent (PS) might prevent against PEP in significantly high-risk patients (score ≥6).
  
  
  CONCLUSIONS
  Both patient-related and procedure-related risk factors are important for predicting PEP and post-ERCP hyperamylasemia. Technical procedures, for example, PS, are necessary to prevent PEP in patients at the highest risk.
authors.affiliation: Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Qi Bin
authors.initials: QB
authors.lastname: He
authors.affiliation: Department of Vasculocardiology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Te
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Infectious Disease, The First People's Hospital of Changzhou, Changzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Yun Hong
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Zou
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000209:etiology*; D007565:Jaundice / Q000150:complications; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors
keywords: endoscopic retrograde cholangiopancreatography; hyperamylasemia; post-ERCP pancreatitis; risk factors; scoring system