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Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis

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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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Authors and Affiliations

  1. Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea

    Chan Hyuk Park

  2. Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea

    Se Woo Park & Da Hae Park

  3. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea

    Min Jae Yang

  4. Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea

    Sung Hoon Moon

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  1. Chan Hyuk Park
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Contributions

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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Correspondence to Se Woo Park.

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Disclosures

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

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