title: Obesity with abundant subcutaneous adipose tissue increases the risk of post-ERCP pancreatitis.
abstract: OBJECTIVE
  The risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) have been widely investigated. However, studies focusing on the body mass index (BMI) and distribution of adipose tissue have not been reported. Therefore, we examined the correlation between PEP and these factors.
  
  
  METHODS
  A total of 583 consecutive endoscopic retrograde cholangiopancreatography (ERCP)-naïve patients undergoing therapeutic ERCP were retrospectively analyzed. Subjects were categorized into four groups by BMI: underweight, normal, overweight, and obesity; the PEP rates were compared. In addition, the relationship between PEP and parameters of obesity, visceral and subcutaneous adipose tissue as well as abdominal circumference was investigated.
  
  
  RESULTS
  PEP rate was significantly higher in obesity (30 %) and lower in normal (3 %, P < 0.001). The PEP rate in underweight (7.3 %) was conversely higher than in normal. As for parameters of obesity, only subcutaneous adipose tissue was correlated with PEP incidence (P = 0.009). The correlation of PEP incidence with BMI and subcutaneous adipose tissue was separately reconfirmed by multivariate analysis including female gender and guidewire placement; these factors showed a tendency toward differences in univariate analysis.
  
  
  CONCLUSIONS
  Obesity could be a risk factor for PEP. In the obesity group, an excess of subcutaneous adipose tissue might be an especially important factor related to PEP incidence.
authors.affiliation: Department of Gastroenterology, NTT Medical Centre Tokyo, Tokyo, Japan. toshio.fujisawa@east.ntt.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujisawa
authors.affiliation: Department of Gastroenterology, NTT Medical Centre Tokyo, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kagawa
authors.affiliation: Department of Gastroenterology, NTT Medical Centre Tokyo, Tokyo, Japan.
authors.forename: Kantaro
authors.initials: K
authors.lastname: Hisatomi
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterology, NTT Medical Centre Tokyo, Tokyo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050218:Body Fat Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000473:pathology; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D050151:Subcutaneous Fat; D055105:Waist Circumference
keywords: Body mass index; Obesity; Post-ERCP pancreatitis; Subcutaneous adipose tissue; Visceral adipose tissue