PREDICTORS OF POST-ERCP COMPLICATIONS IN PATIENTS WITH SUSPECTED CHOLEDOCHOLITHIASIS

Background and Study Aims: Determinants of complications after endosco pic retrograde cholangiopancreatography (ERCP) have not yet been compl etely characterized, Patients and Methods: Data were collected from an endoscopic database. Univariate analysis and multivariate logistic re gression analysis were used to generate the best model of independent predictors of post-ERCP pancreatitis, Results: The database included 1 239 ERCP examinations carried out to investigate suspected choledochol ithiasis over a five-year period. From these, 45 patients who develope d post-ERCP complications were compared to a random sample of 486 pati ents who had undergone an uncomplicated ERCP for suspected choledochol ithiasis, Univariate analysis demonstrated significant differences bet ween the two patient groups for the following factors: age, using a cu t-off point of 59 years (27% vs. 51%, P = 0.002), pancreatic channel o pacification (73% vs. 58%, P = 0.05), and absence of common bile duct stones (41% vs. 24%, P = 0.03), Using multivariate logistic regression , the best model for predicting post-ERCP pancreatitis in patients und ergoing sphincterotomy included age under 59 years (P = 0.04), and abs ence of a common bile duct stone (P = 0.004), The model yielded probab ilities of developing post-sphincterotomy pancreatitis that ranged fro m 2.8% if no predictor was present, to 27% when both predictors were p resent. Among patients in whom a sphincterotomy was not performed, the only significant independent predictor found was pancreatic channel o pacification (P = 0,05), Conclusion: Age under 59 years, pancreatic ch annel opacification, and an absence of common bile duct stones at ERCP are all independent predictors of post-ERCP pancreatitis.