Risk factors for post‐ ERCP pancreatitis and hyperamylasemia: A retrospective single‐center study

Objective With an increased use of endoscopic retrograde cholangiopancreatography ( ERCP ), post‐ERCP complications have attracted much attention. We aimed to identify independent risk factors of post‐ ERCP pancreatitis ( PEP ) and hyperamylasemia, and to develop a simple scoring system of the factors contributing to the clinical prevention against PEP . Methods A retrospective single‐center analysis was performed in 4234 ERCP procedures between S eptember 2007 and D ecember 2012. Patient‐related and procedure‐related risk factors for PEP and post‐ERCP hyperamylasemia were identified by univariate and multivariate regression analyses. A scoring system was developed based on the independent risk factors. Results PEP occurred in 226 (5.3%) ERCP procedures and hyperamylasemia in 774 (18.3%) procedures. Female gender (odds ratio [ OR ] 1.449), first‐time ERCP ( OR 1.745), latent jaundice ( OR 1.917), difficult cannulation ( OR 3.317) and pancreatography ( OR 1.823) were all proven to be significant risk factors for predicting PEP . In addition, difficult cannulation ( OR 1.990) and pancreatography ( OR 2.009), age <60 years ( OR 1.294), prior diabetes ( OR 0.614), biliary duct stent placement ( OR 1.884) and nasobiliary drainage ( OR 1.613) were associated with developing hyperamylasemia. Prophylactic pancreatic duct stent ( PS ) might prevent against PEP in significantly high‐risk patients (score ≥6). Conclusions Both patient‐related and procedure‐related risk factors are important for predicting PEP and post‐ERCP hyperamylasemia. Technical procedures, for example, PS , are necessary to prevent PEP in patients at the highest risk.