Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2025
Normal serum bilirubin level is the risk factor for post-ERCP pancreatitis in Sphincter of Oddi dysfunction types I and II.
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Mamontov Ivan, Ryabushchenko Dmitro, Tamm Tamara, Kramarenko Kostyantin, Dghaili Samer
Аннотация
OBJECTIVE: Aim: To evaluate the risk factors for PEP in SOD types I and II.
PATIENTS AND METHODS: Materials and Methods: We retrospectively analyzed 107 cases of SOD type I, II with undergoing ERCP. Potential risk factors for PEP were investigated: age<60 years, gender, history of cholecystectomy, history of EST, normal serum bilirubin level, common bile duct≤10 mm, gallbladder stones, periamullary diverticulum, papilla size ≥15 mm, initial ERCP success, selective biliary cannulation, pancreatic cannulation/injection, Precut and EST. Factors both significant (p<0.05) for univariate and multivariate analyses were identified as independent risk factor for PEP.
RESULTS: Results: The overall PEP rate was 14% (15/107). Univariate analysis (ꭓ2) showed that only bilirubin level was significantly (p<0.05) associated with PEP. Multivariate analysis by multinomial regression showed that two factors were associated with PEP - normal bilirubin level (OR 9.574, 95% CI 1.869-49.034, p=0.007) and Precut (OR 0.116, 95% CI 0.014-0.979, p=0.048).
CONCLUSION: Conclusions: Normal serum bilirubin level is an independent risk factor for PEP in patients with Type I and Type II of SOD. In cases of suspected or confirmed Type I, II of SOD with normal bilirubin level, ERCP with EST should be avoided and replaced by medical treatment or, if ERCP had been chosen, advanced PEP prophylactic measures should be done.
PATIENTS AND METHODS: Materials and Methods: We retrospectively analyzed 107 cases of SOD type I, II with undergoing ERCP. Potential risk factors for PEP were investigated: age<60 years, gender, history of cholecystectomy, history of EST, normal serum bilirubin level, common bile duct≤10 mm, gallbladder stones, periamullary diverticulum, papilla size ≥15 mm, initial ERCP success, selective biliary cannulation, pancreatic cannulation/injection, Precut and EST. Factors both significant (p<0.05) for univariate and multivariate analyses were identified as independent risk factor for PEP.
RESULTS: Results: The overall PEP rate was 14% (15/107). Univariate analysis (ꭓ2) showed that only bilirubin level was significantly (p<0.05) associated with PEP. Multivariate analysis by multinomial regression showed that two factors were associated with PEP - normal bilirubin level (OR 9.574, 95% CI 1.869-49.034, p=0.007) and Precut (OR 0.116, 95% CI 0.014-0.979, p=0.048).
CONCLUSION: Conclusions: Normal serum bilirubin level is an independent risk factor for PEP in patients with Type I and Type II of SOD. In cases of suspected or confirmed Type I, II of SOD with normal bilirubin level, ERCP with EST should be avoided and replaced by medical treatment or, if ERCP had been chosen, advanced PEP prophylactic measures should be done.