Incidence and risk factors for post-ERCP pancreatitis in pancreas divisum patients without chronic pancreatitis

Scand J Gastroenterol. 2020 Jun;55(6):732-736. doi: 10.1080/00365521.2020.1774922. Epub 2020 Jun 22.

Abstract

Aims: The studies on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in pancreas divisum (PD) patients without chronic pancreatitis (CP) are rare. In this study, we aimed to evaluate the incidence of PEP in PD patients without CP and the risk and protective factors for PEP.Methods: Consecutive patients with symptomatic PD that underwent ERCP from January 2005 to December 2017 were retrospectively analyzed. The patients were divided into PD without CP group and CP group. The basic information and medical records of patients were collected. The risk and protective factors for PEP in PD patients without CP were analyzed by univariate logistic analysis.Results: A total of 89 ERCP procedures were performed in 51 PD patients without CP, and 249 procedures in 136 patients with CP. The incidence of PEP was significantly higher in PD patients without CP than those with CP (15.7% vs. 5.6%, p = .005). Female gender were independent risk factors for PEP, while dorsal duct stent placement was a protective factor.Conclusion: CP may be a protective factor against PEP in PD patients. Female was a risk factor for PEP in PD patients and dorsal duct stent placement was a preventive factor that reduced the incidence of PEP in PD patients without CP.

Keywords: Pancreas divisum; chronic pancreatitis; endoscopic retrograde cholangiopancreatography; post-endoscopic retrograde cholangiopancreatography pancreatitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pancreas / abnormalities*
  • Pancreas / diagnostic imaging
  • Pancreatitis, Chronic / epidemiology
  • Pancreatitis, Chronic / etiology*
  • Protective Factors
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Sex Factors
  • Young Adult