title: Is ESR Important for Predicting Post-ERCP Pancreatitis?
abstract: BACKGROUND
  Pancreatitis remains the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), resulting in substantial morbidity and occasional mortality. There are notable controversies and conflicting reports about risk factors of post-ERCP pancreatitis (PEP).
  
  
  OBJECTIVE
  To evaluate the potential risk factors for PEP at a referral tertiary center, as a sample of the Iranian population.
  
  
  METHODS
  Baseline characteristics and clinical as well as paraclinical information of 780 patients undergoing diagnostic and therapeutic ERCP at Taleghani hospital in Tehran between 2008 and 2012 were reviewed. Data were collected prior to the ERCP, at the time of the procedure, and 24-72 hours after discharge. PEP was diagnosed according to consensus criteria.
  
  
  RESULTS
  Of the 780 patients who underwent diagnostic ERCP, pancreatitis developed in 26 patients (3.3%). In the multivariable risk model, significant risk factors with adjusted odds ratios (ORs) were age <65 years (OR = 10.647, P = 0.023) and erythrocyte sedimentation rate (ESR) >30 (OR = 6.414, P < 0.001). Female gender, history of recurrent pancreatitis, pre-ERCP hyperamylasemia, and difficult or failed cannulation could not predict PEP. There was no significant difference in the rate of PEP in wire-guided cannulation versus biliary cannulation using a sphincterotome and contrast injection as the conventional method.
  
  
  CONCLUSIONS
  Performing ERCP may be safer in the elderly. Patients with high ESR may be at greater risk of PEP, which warrants close observation of these patients for signs of pancreatitis after ERCP.
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Amir Houshang
authors.initials: AH
authors.lastname: Mohammad Alizadeh
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Esmaeil Shamsi
authors.initials: ES
authors.lastname: Afzali
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Catherine
authors.initials: C
authors.lastname: Behzad
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Mirhadi
authors.initials: M
authors.lastname: Mousavi
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Dariush
authors.initials: D
authors.lastname: Mirsattari
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Siavash Zafar
authors.initials: SZ
authors.lastname: Doagoo
authors.affiliation: Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zali
keywords: cholangiopancreatography; complication; pancreatitis