Abstract
Background
Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common serious adverse event. Given recent endoscopic advances, we aimed to develop and validate a risk prediction model for PEP using the latest clinical database.
Methods
We analyzed the data of patients with naïve papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP). Pre-ERCP and post-ERCP risk prediction models for PEP were developed using logistic regression analysis. Patients were classified into low- (0 points), intermediate- (1–2 points), and high-risk (≥ 3 points) groups according to point scores.
Results
We included 760 and 735 patients in the derivation and validation cohorts, respectively. The incidence of PEP was 5.5% in the derivation cohort and 3.9% in the validation cohort. Age ≤ 65 (1 point), female sex (1 point), acute pancreatitis history (2 points), malignant biliary obstruction (2 points [pre-ERCP model] or 1 point [post-ERCP model]), and pancreatic sphincterotomy (2 points, post-ERCP model only) were independent risk factors. In the validation cohort, the high-risk group (≥ 3 points) had a significantly higher risk of PEP compared to the low- or intermediate-risk groups under the post-ERCP risk prediction model (low: 2.0%; intermediate: 3.4%; high: 18.4%), while there was no significant between-group difference under the pre-ERCP risk prediction model (low: 2.2%; intermediate: 3.8%; high: 6.9%).
Conclusions
We developed and validated pre-ERCP and post-ERCP risk prediction models. In the latter, the high-risk group had a higher risk of PEP development than the low- or intermediate-risk groups. Our study findings will help clinicians stratify patient risk for the development of PEP.
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SWP contributed to conception and design of the study. CHP, SWP, MJY, SHM, and DHP were involved in generation, collection, assembly, analysis, and/or interpretation of data. CHP and SWP drafted or revised the manuscript and approved the final version of the manuscript.
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Chan Hyuk Park, Se Woo Park, Min Jae Yang, Sung Hoon Moon, and Da Hae Park have no conflicts of interest or financial ties to disclose.
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Park, C.H., Park, S.W., Yang, M.J. et al. Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis. Surg Endosc 36, 2052–2061 (2022). https://doi.org/10.1007/s00464-021-08491-1
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DOI: https://doi.org/10.1007/s00464-021-08491-1