FREQUENCY AND CONTRIBUTING FACTORS FOR ACUTE PANCREATITIS AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

Contributing Factors For Post ERCP Acute Pancreatitis With Obstructive Jaundice

Abstract

Objective: To evaluate the frequency and contributing factors for acute pancreatitis after endoscopic retrograde cholangio-pancreatography in patients with obstructive jaundice.
Study Design: Descriptive case series.
Place and Duration of Study: A descriptive case series conducted at department of Gastroenterology, Shaikh Zayed Hospital, Lahore in the period of six months.
Material and Methods: Two hundred and thirty patients diagnosed as having obstructive jaundice and
undergoing ERCP who fulfilled the inclusion criteria were included in the study from the outpatient and indoor
department of Gastroenterology-Hepatology Shaikh Zayed Hospital Lahore. Informed consent was taken. After the selection of the cases, patients were evaluated for the presence or absence of contributing factors like age, gender, cannulation attempts, cannulation time, percutaneous papillotomy, pancreatic duct contrast injection and previous history of post ERCP pancreatitis. Data was analysed by using the statistical software for social sciences (SPSS) version 15.
Results: In our study, mean age was 44 ± 14.12 years. Out of 230 patients 42.17% (n=97) were male and 57.83% (n=133) were females. Frequency of acute pancreatitis after ERCP in patients with obstructive jaundice was 4.78% (n=11) while 95.22% (n=219) had no findings of acute pancreatitis after ERCP. Frequency of factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was recorded which shows that out of 11 cases, 45.45% (n=5) were females, 36.36% (n=4) had previous history of Post ERCP Pancreatitis, 27.27% (n=3) had >5 attempts of cannulation, 36.36% (n=4) had >5 minute time for cannulation, 54.55% (n=6) had pre-cut papillotomy while 63.64% (n=7) had pancreatic duct contrast injection.
Conclusion: We concluded that frequency of acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was found not very high in our practice. Female gender, precut papillotomy and pancreatic duct contrast injection were the most important risk factors for the development of acute pancreatitis.