Meta Analysis Of Risk Factors For Post-ERCP Pancreatitis In Patient Characteristics And Surgical Operation

Background and objective: Post-ERCP pancreatitis is the most common and serious complication of ERCP.Prevention is important to reduce the incidence of post-ERCP pancreatitis.However,the risk factors for post-ERCP pancreatitis(PEP)remain controversial.In this study,risk factors for PEP were determined by Meta-analysis.Methods: Retrieval databases,including PubMed,Embase,Cochrane library,cnki,wanfang,and vip,limited to Chinese and English,and literatures were collected as of February 2020.Inclusion and exclusion criteria are predetermined.Fifteen possible risk factors were evaluated and the results of dichotomous variables were expressed as odds ratios(OR)(95% confidence intervals(CI)).Results: After analyzing the risk factors of patients,for females,OR=1.51(95%CI=1.32-1.73);for age < 60 years old,OR=1.59(95%CI=1.27-1.99);for history of pancreatitis,OR=5.66(95%CI=4.30-7.44);for SOD,OR=3.77(95%CI=2.04-6.97);for history ofcholecystectomy,OR=1.45(95%CI=1.15-1.82);for hypertension,OR=1.09(95%CI=0.89-1.33);for jaundice,OR=0.78(95%CI=0.54-1.14);for bile duct dilatation,OR=0.75(95%CI=0.56-1.02);for diabetes,OR=0.94(95%CI=0.70-1.26);for choledocholithiasis,OR=0.54(95%CI=0.18-1.62);for enhancement of the pancreatic duct,OR=3.55(95%CI=1.93-6.53);for EST,OR=1.21(95%ci =0.90-1.64);for stenting of the pancreatic duct,OR=0.99(95%CI=0.50-1.99);for bile duct stent implantation,OR=1.26(95%CI=0.79-2.00);for nasobiliary drainage,OR=0.44(95%CI=0.20-1.00).Conclusion: In terms of patient characteristics,female,age < 60 years old,history of pancreatitis,SOD and history of cholecystectomy were risk factors for PEP.Hypertension,jaundice,bile duct dilatation,diabetes,choledocholithiasis had no significant correlation with the occurrence of PEP.In terms of surgical operation,enhancement of the pancreatic duct was a risk factor for PEP.There was no significant correlation between EST,stenting of the pancreatic duct,bile duct stent implantation,nasobiliary drainage and the occurrence of PEP.