Risk Factors for Post Endoscopic Retrograde Cholangio Pancreatography(ERCP) Pancreatitis (PEP) and Efficacy of Octreotide in its Prevention

Risk Factors for Post Endoscopic Retrograde Cholangio Pancreatography(ERCP) Pancreatitis (PEP) and Efficacy of Octreotide in its Prevention

Authors

  • Abdul Aleem
  • Shahid Sarwar
  • Yasir Mahmud

DOI:

https://doi.org/10.21649/akemu.v28i4.5308

Keywords:

ERCP, Octreotide, Pancreatitis, Risk factors

Abstract

Background: Pancreatitis is a potentially fatal complication of ERCP, seen in 5-15% procedures. Factors precipitating its risk and effective pharmacological intervention for its prevention need exploration to improve patient safety. Objective: To identify risk factors for post-ERCP pancreatitis (PEP) and to determine efficacy of intravenous octreotide in preventing PEP. Methodology: A quasi-experimental triple blind placebo-based study included patients undergoing ERCP and randomize them in two groups through simple random sampling. Group A to receive intravenous Octreotide 4μg/kg before attempting cannulation during ERCP and 1cc N/S as placebo for group B. Patients were followed for PEP and data were analyzed using chi square (x2) and logistic regression analysis. Results: Of 203 included patients, 101 (49.3%) received octreotide while 102 (50.7%) were in control group. Post ERCP pancreatitis developed in 32 (15.8%) patients, in 8 (7.9%) patients of octreotide group while in 24 (23.8%) patients of control group (p value 0.002 with odds ratio (OR) for octreotide of 0.33 (95% CI 0.15- 0.71). We identified biliary surgery (p value 0.005), serum bilirubin ≥ 3 mg/dl (p value 0.03), cannulation time > 5 minutes (p value <0.000), needle knife sphincterotomy (p value 0.002), deep pancreatic duct (PD) cannulation (p value <0.000) and procedure time>30 minutes (p value 0.002) as risk factors for PEP. Conclusion: Previous biliary surgery, high serum bilirubin, cannulation time > 5 minutes, use of needle knife, PD cannulation and procedure time > 30 minutes are associated with increased risk of PEP. Intravenous octreotide before cannulation reduces risk of post ERCP pancreatitis.

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Published

02/25/2023

How to Cite

Aleem, A. ., Sarwar, S. ., & Mahmud, Y. . (2023). Risk Factors for Post Endoscopic Retrograde Cholangio Pancreatography(ERCP) Pancreatitis (PEP) and Efficacy of Octreotide in its Prevention. Annals of King Edward Medical University, 28(4), 387–392. https://doi.org/10.21649/akemu.v28i4.5308

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