Background

The most common complication of endoscopic retrograde cholangiopancreatography (ERCP) is acute pancreatitis (PEP), which occurs in 4%–5.1% of patients; however, depending on the prevalence of risk factors, the incidence may grow– to 7.8%–29.2%. It is therefore important to determine the pre-and intraprocedural risk factors and establish guidelines to proper assess the risks during ERCP.

Aims

Determine the pre-and intraprocedural risk factors and establish guidelines to assess the risks during ERCP.

Methods

The study group included 402 patients who underwent an endoscopic sphincterotomy. We evaluated 29 variables according to a three–stage assessment system: Stage I - during the qualification (seventeen variables), Stage II affecting the decision of two-stage access (eight variables), and Stage III – affecting the decision of two-stage procedure (four variables).

Results

The significant variables based on univariate and multivariate logistic regression analyses were as follows: during the first stage, age below 40 (OR = 6.9, p = 0.0004; OR = 5.2, p = 0.0032) and narrowed common bile duct ( CBD)(OR 5.3, p = 0.0007; OR = 4.4, p = 0.0037); at the second stage, non-prominent papillae (OR = 5.1, p = 0.0049; OR = 5.3, p= 0.0039) and difficult cannulation (OR = 3.2, p = 0.0298; OR= 3.4, p= 0.0227); and at the third stage, post-sphincterotomy bleeding (OR 3.6, p = 0.0148; OR = 3.6, p=0.015).

Conclusion

The obtained results determined five PEP risk factors: age