Analysis Of The Risk Factors Of Post ERCP Pancreatitis And Its Prevention

objective:To investigate the risk factors of post ERCP pancreatitis and put forward effective prevention measures based on the results and combined with literature.Methods:We collected the hospital information of the168patients who hospitalized in the first affiliated hospital of shanxi medical university during October2010to July2013to undergo ERCP examination or treatment. We filtered the data according to certain inclusion and exclusion standards.For the cases conformed to the standard we first used single factor analysis to analyze the relationship of gender, age, obesity, jaundice, anesthesia, number of intubation, numuber of pancreatic duct image, sphincter of Oddi dysfunction, papillary sphincter incision, nose bile duct drainage, bile duct stenting and post-ERCP pancreatitis respectively.For the factors which had statistically significan in single factor analysis,we put them into unconditioned Logistic regression analysis to further screen independent risk factors of post ERCP pancreatitis.Results:153of the168collected cases were conformed to the inclusion standard, not accord with the exclusion standard..Of the153cases19patients occurred post ERCP pancreatitis.The rate was12.42%.9of the25factors showed statistical significance in single factor analysis.They were gender (female), age (<60years old), history of pancreatitis, sphincter of Oddi dysfunction (SOD), number of intubation (3or higher), pancreatic duct intubation, developing of pancreatic duct, times of Injection of contrast agent (>2) and nasal biliary drainage.We took the9facters in unconditioned Logistic regression analysis and selectrd four variables.The result showed women (OR:4.240,95%CI:0.797-22.545),sphincter of Oddi dysfunction (OR:5.715,95%CI:0.988-33.052), repeated intubation (OR:8.540,95%CI:1.746-41.761) were independent risk factors for post-ERCP pancreatitis, and nasal biliary drainage (OR:0.234,95%CI:0.058-0.947) was protection factor of post-ERCP pancreatitis. The prevention of post ERCP pancreatitis include the selection of patients,endoscopic technology and drug prevention. Strictly conforming the ERCP indications and contraindications, assessing the risk preoperatively, gentle and careful operation intraoperatively, inviting a superior expert to guide when necessary,liening a nose bile duct postoperatively, preventively using somatostatin, Octreotide, antibiotics and other drugs can effectively prevent the happening of post ERCP pancreatitis. Conclusion:Women, sphincter of Oddi dysfunction, repeated intubation are risk factors of post-ERCP pancreatitis, and nasal biliary drainage can prevent the occurrence of post-ERCP pancreatitis. Strictly grasping the ERCP indications and contraindications, liening nasal biliary drainage and prophylactic using of somatostatin and other drugs if necessary can effectively prevent the happening of post ERCP pancreatitis.