International Journal of
Medicine and Medical Sciences

  • Abbreviation: Int. J. Med. Med. Sci.
  • Language: English
  • ISSN: 2006-9723
  • DOI: 10.5897/IJMMS
  • Start Year: 2009
  • Published Articles: 531

Full Length Research Paper

Impact of patient- and intervention-related factors on the outcome of acute biliary pancreatitis treated by urgent ERCP and biliary sphincterotomy

József Pozsár
  • József Pozsár
  • Department of Gastroenterology, Szent Imre Hospital, Budapest, Hungary.
  • Google Scholar
Ferenc László
  • Ferenc László
  • Department of Comparative Physiology, University of Szeged, Szeged, Hungary.
  • Google Scholar
Ildikó Brandhuber
  • Ildikó Brandhuber
  • Medical Faculty, Semmelweis University, Budapest, Hungary.
  • Google Scholar
Péter Sahin
  • Péter Sahin
  • Department of Gastroenterology, Szent Imre Hospital, Budapest, Hungary.
  • Google Scholar
Lajos Topa
  • Lajos Topa
  • Department of Gastroenterology, Szent Imre Hospital, Budapest, Hungary.
  • Google Scholar


  •  Accepted: 29 June 2010
  •  Published: 30 October 2010

Abstract

Risk factors of post- ERCP pancreatitis are well characterized in various clinical settings. These factors may worsen the outcome of acute biliary pancreatitis treated by endoscopic sphincterotomy. Our aim was to investigate the effect of patient- and intervention- related factors on the outcome of acute biliary pancreatitis treated by endoscopic sphincterotomy. The data of 69 retrospectively analyzed using multiple logistic regression method to explore factors significantly associated with the outcome of pancreatitis. We found that multi-system organ failure was associated with predicted severe pancreatitis (odds ratio [OR] 24.24; 95% confidence interval [CI]: 1.35 – 434.76; p = 0.030), condition of previous cholecystectomy (OR 23.94; 95% CI: 1.58 – 361.03; p = 0.022) and the performance of access precut sphincterotomy (OR 21.34; 95% CI: 1.32 – 344.92; p = 0.031). Predictors of development of necrosis were post-sphincterotomy bleeding (OR 52.01; 95% CI: 1.67 – 1617.54; p = 0.024), the predicted severe pancreatitis at admission (OR 20.30; 95% CI: 2.92 – 141.19; p = 0.002) and female gender (OR 6.70; 95% CI: 1.00 – 44.73; p = 0.049). The single variable post-cholecystectomy state proved to be a predictor of mortality (OR 13.40; 95% CI: 1.5-∞; p = 0.026). We concluded that the outcome of acute biliary pancreatitis treated by ERCP and biliary sphincterotomy of acute biliary pancreatitis is influenced by certain patient- and intervention-related factors.

Key words: Acute biliary pancreatitis, sphincterotomy, risk- factors, outcome.