Disease-Based Risk Stratification of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis for Common Bile Duct Stones

Saito Hirokazu; Sakaguchi Masafumi; Kadono YoshihiroShono TakashiKamikawa KentaroUrata AtsushiNasu JiroImamura HaruoMatsushita IkuoKakuma TatsuyukiTada Shuji

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Disease-Based Risk Stratification of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis for Common Bile Duct Stones

机译：Disease-Based Risk Stratification of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis for Common Bile Duct Stones

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Background Risk stratification of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) for common bile duct (CBD) stones is needed for clinicians to adequately explain to patients regarding the risk of PEP in advance of ERCP and to proactively take preventive measures in high-risk patients. Aims To stratify the risk of PEP for CBD stones based on CBD-related diseases. Methods A total of 1551 patients with naive papilla who underwent ERCP for CBD stones were divided into three groups: Group A: asymptomatic CBD stones, Group B: obstructive jaundice and elevated liver test values without cholangitis, and Group C: mild, moderate, and severe cholangitis. We stratified the risk of PEP by comparing its incidence among the three groups using the Holm's method. Furthermore, we performed one-to-one propensity score matching between Group A and the other groups to examine the risk of PEP in Group A. Results The incidence rates in Groups A, B, and C were 13.7%, 7.3%, and 1.8%, respectively. The Holm-adjusted p values between Groups A and B, Groups A and C, and Groups B and C were 0.023, < 0.001, and < 0.001, respectively. Propensity score matching revealed that the incidence of PEP was significantly more in Group A than in the other groups (13.3% vs. 1.5%; p < 0.001). Conclusions The risk of PEP for CBD stones was stratified into low risk (Group C), intermediate risk (Group B), and high risk (Group A). This simple disease-based risk stratification may be useful to predict the risk of PEP in advance of ERCP.

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《Digestive Diseases and Sciences》 |2022年第1期|305-314|共10页
作者
Saito Hirokazu; Sakaguchi Masafumi; Kadono YoshihiroShono TakashiKamikawa KentaroUrata AtsushiNasu JiroImamura HaruoMatsushita IkuoKakuma TatsuyukiTada Shuji;
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作者单位

Dept Gastroenterol,Kumamoto City Hosp;

Dept Gastroenterol,Saiseikai Kumamoto Hosp;

Dept Gastroenterol,Tsuruta HospDept Gastroenterol Surg,Kumamoto City HospMed Sch,Kurume Univ;

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正文语种英语
中图分类消化系及腹部疾病;
关键词
Biliary tract; Common bile duct; Endoscopic retrograde; Pancreatitis; Risk assessment;

Disease-Based Risk Stratification of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis for Common Bile Duct Stones

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