Incidence and risk factors for post-ERCP pancreatitis in pancreas divisum patients without chronic pancreatitis

Abstract

Aims: The studies on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in pancreas divisum (PD) patients without chronic pancreatitis (CP) are rare. In this study, we aimed to evaluate the incidence of PEP in PD patients without CP and the risk and protective factors for PEP.

Methods: Consecutive patients with symptomatic PD that underwent ERCP from January 2005 to December 2017 were retrospectively analyzed. The patients were divided into PD without CP group and CP group. The basic information and medical records of patients were collected. The risk and protective factors for PEP in PD patients without CP were analyzed by univariate logistic analysis.

Results: A total of 89 ERCP procedures were performed in 51 PD patients without CP, and 249 procedures in 136 patients with CP. The incidence of PEP was significantly higher in PD patients without CP than those with CP (15.7% vs. 5.6%, p = .005). Female gender were independent risk factors for PEP, while dorsal duct stent placement was a protective factor.

Conclusion: CP may be a protective factor against PEP in PD patients. Female was a risk factor for PEP in PD patients and dorsal duct stent placement was a preventive factor that reduced the incidence of PEP in PD patients without CP.

Keywords:

• Pancreas divisum
• endoscopic retrograde cholangiopancreatography
• post-endoscopic retrograde cholangiopancreatography pancreatitis
• chronic pancreatitis

Author contributions

BY, YJ, SYH and LZS conceived and designed the experiments. MQQ, ZSB and WZJ collected and check the data. MQQ, ZSB, WZJ and SZ made critical revision of the manuscript for important intellectual content. XT, WSL, ZSB, GL, PP and MQQ analyzed the data. MQQ wrote the paper. All authors approved the final submission.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

Dr. Bai Yu is supported by the National Key R&D Program of China [2017YFC1308800, 2018YFC1313103], and National Natural Science Foundation of China [Grant No. 81670473 and 81873546], “Shu Guang” project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation [No. 19SG30], and Three Engineering Training Funds in Shenzhen [No. SYLY201718]. Dr. Jun Yao is supported by the National Natural Science Foundation of China [grant no. 81800489], and three engineering training funds in Shenzhen, no. SYLY201718, Technical Research and Development Project of Shenzhen JCYJ20150403101028164, and no. JCYJ20170307100538697.