AIM: of our study was to assess risk factors for post ERCP/ES acute pancreatitis due to endoscopic maneuvers on Vater's papilla in a prospective Italian multicentric study. METHOD: A 400-variable data-base considering variable of procedure, indication for procedure, the clinical condition of the patient, the morphology of the papilla, of biliary and pancreatic ducts and the associated procedure or stenting, was collected for all patients undergoing ERCP/ES in 12 centres in Lombardia. RESULT: 1693 patients submitted to 1908 procedures on biliary and pancreatic ducts were included in the study. 97 complications were observed with 3 related deaths. The most frequent complication that we observed was the acute pancreatitis. An attack of acute pancreatitis was observed in 31 patients (1.6%), mild in 26 (1.36%) and necrotizing in 5 (0.26%). In all cases, the outcome of acute pancreatitis was favorable requiring surgery in 2 of the necrotizing forms and conservative treatment in all the rest. Comparing patients with this complication, with overall patients submitted to ERCP/ES, were observed a positive correlation for acute pancreatitis with needle-knife ES (p <0.05), injection of pancreatic duct (p <0.007) and acinarization (p <0.0001). No related factors were failure of cannulation, repeated injection of pancreatic duct, injection of biliary ducts only, CBD <1 cm, small papilla and pre-cut. CONCLUSIONS: The incidence of post ERCP/ES complications in our series is lower to that reported in recent large prospective series in the literature. Factors which increase risk of pancreatitis only include opacification of pancreatic ducts and acinarization.
|Publication status||Published - 1997|
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