ISSN 2756-3820
International Journal of Medical Sociology and Anthropology Vol. 9 (7), pp. 001-013, July, 2020. © International Scholars Journals
Full Length Research paper
Impact of patient- and intervention-related factors on the outcome of acute biliary pancreatitis treated by urgent ERCP and biliary sphincterotomy
József Pozsár1*, Ferenc László2, Ildikó Brandhuber3, Péter Sahin1 and Lajos Topa1
1Department of Gastroenterology, Szent Imre Hospital, Budapest, Hungary.
2Department of Comparative Physiology, University of Szeged, Szeged, Hungary.
3Medical Faculty, Semmelweis University, Budapest, Hungary.
Accepted 19 June, 2020
Abstract
Risk factors of post- ERCP pancreatitis are well characterized in various clinical settings. These factors may worsen the outcome of acute biliary pancreatitis treated by endoscopic sphincterotomy. Our aim was to investigate the effect of patient- and intervention- related factors on the outcome of acute biliary pancreatitis treated by endoscopic sphincterotomy. The data of 69 retrospectively analyzed using multiple logistic regression method to explore factors significantly associated with the outcome of pancreatitis. We found that multi-system organ failure was associated with predicted severe pancreatitis (odds ratio [OR] 24.24; 95% confidence interval [CI]: 1.35 – 434.76; p = 0.030), condition of previous cholecystectomy (OR 23.94; 95% CI: 1.58 – 361.03; p = 0.022) and the performance of access precut sphincterotomy (OR 21.34; 95% CI: 1.32 – 344.92; p = 0.031). Predictors of development of necrosis were post- sphincterotomy bleeding (OR 52.01; 95% CI: 1.67 – 1617.54; p = 0.024), the predicted severe pancreatitis at admission (OR 20.30; 95% CI: 2.92 – 141.19; p = 0.002) and female gender (OR 6.70; 95% CI: 1.00 – 44.73; p = 0.049). The single variable post- cholecystectomy state proved to be a predictor of mortality (OR 13.40; 95% CI: 1.5- ; p = 0.026). We concluded that the outcome of acute biliary pancreatitis treated by ERCP and biliary sphincterotomy of acute biliary pancreatitis is influenced by certain patient- and intervention-related factors.
Key words: Acute biliary pancreatitis, sphincterotomy, risk- factors, outcome.