Analysis Of The Risk Factors Of Hyperamylasemia Post-ERCP For Patients With Choledocholithiasis

Objective:Retrospectively analyze the risk factors of hyperamylasemia after encoscopic retrograde cholangio pancreatography(ERCP)which removed stones for patients with choledocholithiasis.Provide theoretical basis for prevention of hyperamylasemia after ERCP,guide clinical treatment.Methods:In this study,601 clinical data of patients who had been treated by ERCP in The Affiliated Hospital of Youjiang Medical University for Nationalities from August 2018 to August 2021 were collected.Among which 511 patients met the inclusion criteria according to the diagnostic criteria of hyperamylasemia after ERCP.They were divided into group hyperamylasemia(content of blood amylase≥3 times the upper limit of normal)and group non-hyperamylasemia(content of blood amylase<3 times the upper limit of normal).Method of single factor analysis was used to analyze the personal factors and operation factors.Method of multifactor analysis was used to analyze single factors of P<0.05 to determine the risk factors for choledocholithiasis patients’hyperamylasemia after removing stones by ERCP.Results:According to the diagnostic criteria,511 patients were included in the analysis from 601 patients with choledocholithiasis and removed stones by ERCP.199 patients had hyperamylasemia after ERCP and 312 patients had no hyperamylasemia after ERCP,the morbidity rate of hyperamylasemia was 38.94%.(1)Results of single factor analysis showed that:gender(χ~2=4.328,P=0.037),age(χ~2=6.692,P=0.010),nation(χ~2=5.350,P=0.021),history of gallstone(χ~2=8.593,P=0.003),history of cholecystectomy(χ~2=11.862,P<0.001),neutrophilicgranulocyte(χ~2=23.300,P<0.001),percentage of lymphocytes(χ~2=175.131,P<0.001),hemoglobin(χ~2=4.293,P=0.038),direct bilirubin(χ~2=6.133,P=0.013),albumin(χ~2=8.713,P=0.003),creatinine clearance(χ~2=8.174,P=0.004),intubation into the pancreatic duct and angiography(χ~2=9.503,P=0.002)and mechanical lithotripsy(χ~2=5.234,P=0.022)were significantly different between group of hyperamylasemia and group of non-hyperamylasemia(P<0.05),suggesting that the above factors are the influencing factors of hyperamylasemia after ERCP.(2)Results of multivariate analysis showed that history of gallstones(P=0.030,OR=1.667,95%CI:1.051-2.646),history of cholecystectomy(P=0.002,OR=2.143,95%CI:1.324-3.467),intubation into the pancreatic duct and angiography(P=0.002,OR=2.779,95%CI:1.460-5.289)and mechanical lithotripsy(P=0.022,OR=2.461,95%CI:1.141-5.308)were significantly different between group of hyperamylasemia and group of non-hyperamylasemia(P<0.05),these factors are risk factors of hyperamylasemia after ERCP.Conclusion:Gender,age,nation,history of gallstone,history of cholecystectomy,neutrophilicgranulocyte,percentage of lymphocytes,hemoglobin,direct bilirubin,albumin,creatinine clearance,intubation into the pancreatic duct and angiography,mechanical lithotripsy are the influencing factors for hyperamylasemia after ERCP.History of cholelithiasis,history of cholecystectomy,intubation into the pancreatic duct and angiography,mechanical lithotripsy are risk factors of hyperamylasemia after.