Endoscopy 2003; 35(10): 830-834
DOI: 10.1055/s-2003-42614
Original Article
© Georg Thieme Verlag Stuttgart · New York

Risk Factors for Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography: A Meta-Analysis

E.  Masci1 , A.  Mariani1 , S.  Curioni1 , P.  A.  Testoni1
  • 1Gastroenterology and Endoscopic Unit, S. Raffaele Hospital, Milan, Italy
Further Information

Publication History

Submitted 19 August 2002

Accepted after Revision 3 April 2003

Publication Date:
10 October 2003 (online)

Background and Study Aim: The identification of factors which increase the risk of acute pancreatitis, the most common and most severe complication of endoscopic retrograde cholangiopancreatography (ERCP), is of considerable importance. However, in four large prospective studies, the reported incidence of identified risk factors for post-ERCP pancreatitis was found to be variable. The aim of this study was to identify the most important risk factors for post-ERCP pancreatitis.
Material and Methods: We performed a meta-analysis of 15 prospective clinical studies, selected out of 52 reviewed articles, in which risk factors for pancreatitis were identified. Of the 14 risk factors identified, five were patient characteristics and nine were related to the endoscopic technique.
Results: When patient-related risk factors were analysed, the relative risk for suspected sphincter of Oddi dysfunction was 4.09 (95 % CI 3.37 to 4.96; P < 0.001); for female gender, 2.23 (95 % CI 1.75 to 2.84, P < 0.001); and for previous pancreatitis, 2.46 (95 % CI 1.93 to 3.12, P < 0.001). Two endoscopy-related factors were confirmed: for precut sphincterotomy the relative risk was 2.71 (95 % CI 2.02 to 3.63, P < 0.001); for pancreatic injection the relative risk was 2.2 (95 % CI 1.6 to 3.01, P < 0.001).
Conclusions: This meta-analysis provides a clear basis for planning pharmacological studies or studies of new endoscopic techniques in patients at high risk of developing post-ERCP pancreatitis. Knowing which patients are most at risk may also make it easier to decide who should be considered unsuitable for same-day discharge.

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E. Masci, M. D.

Gastroenterology and Endoscopic Unit · S. Raffaele Hospital

Via Olgettina 60 · 20132 Milan · Italy

Fax: + 39-02-2643-3410

Email: masci.enzo@hsr.it

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