Relationship between Bile Duct Uneven Dilation and Postoperative Pancreatitis after ERCP

Yanyang LI; Kejia LI; Ang LIU; Zhihong ZHANG; Xueyuan DANG; Guohui SHAO; Zhitian SHI; Lin WANG; Dong WEI; Jiayun GE

doi:10.12259/j.issn.2095-610X.S20230311

Volume 44 Issue 3

Mar. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(3): 131-137

Yanyang LI, Kejia LI, Ang LIU, Zhihong ZHANG, Xueyuan DANG, Guohui SHAO, Zhitian SHI, Lin WANG, Dong WEI, Jiayun GE. Relationship between Bile Duct Uneven Dilation and Postoperative Pancreatitis after ERCP[J]. Journal of Kunming Medical University, 2023, 44(3): 131-137. doi: 10.12259/j.issn.2095-610X.S20230311

Citation:

Yanyang LI, Kejia LI, Ang LIU, Zhihong ZHANG, Xueyuan DANG, Guohui SHAO, Zhitian SHI, Lin WANG, Dong WEI, Jiayun GE. Relationship between Bile Duct Uneven Dilation and Postoperative Pancreatitis after ERCP[J]. Journal of Kunming Medical University, 2023, 44(3): 131-137. doi: 10.12259/j.issn.2095-610X.S20230311

Citation:

Yanyang LI, Kejia LI, Ang LIU, Zhihong ZHANG, Xueyuan DANG, Guohui SHAO, Zhitian SHI, Lin WANG, Dong WEI, Jiayun GE. Relationship between Bile Duct Uneven Dilation and Postoperative Pancreatitis after ERCP[J]. Journal of Kunming Medical University, 2023, 44(3): 131-137. doi: 10.12259/j.issn.2095-610X.S20230311

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Relationship between Bile Duct Uneven Dilation and Postoperative Pancreatitis after ERCP

doi: 10.12259/j.issn.2095-610X.S20230311

The second Ward of Hepatobiliary and Pancreatic Surgery，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2022-11-24
Available Online: 2023-03-02
Publish Date: 2023-03-25

Abstract

Abstract

Objective To investigate the relationship between bile duct uneven dilatation and postoperative pancreatitis after ERCP. Methods A total of 247 cases of ERCP+EST + ENBD due to bile duct stone were performed in the Second Affiliated Hospital of Kunming Medical University from January 2018 to December 2021. They were divided into the bile duct dilation group （bile duct diameter ≥10 mm）（group A = 84） and the nondilated group （bile duct diameter < 10 mm）（group B = 163） as control group for statistical processing and comparison. Results There were 84 patients in group A, including 45 females; 9 cases of suspected SOD; there are 30 patients with difficult cannulation, including 22 patients with pancreatic guidewire passages and 8 patients with development of the pancreatic duct; 9 cases of APBDJ.In group A, there were 10 cases of mild pancreatitis, 8 cases of moderate pancreatitis, and 3 cases of severe pancreatitis. There were 163 patients in group B, including 72 females; 11 cases of suspected SOD; there were 63 patients with difficult cannulation, including 61 pancreatic guidewire passages and 2 patients with development of the pancreatic duct; 1 case of APBDJ. In group B, there are 10 cases of mild pancreatitis, 1 case of moderate pancreastitis, and 4 cases of severe pancreatitis. There were 30 patients in group A and 57 patients in group B who received indomethacin anal embolus. The incidence of PEP was 25% in group A and 9.2% in group B, and the difference between the two groups was statistically significant （P = 0.001）. Logistic univariate regression analysis of 247 patients showed that bile duct dilatation （OR = 3.289, 95%CI = 1.593～6.792, P = 0.001） was an independent risk factor for PEP. Conclusions Female patient with uneven bile duct dilation （bile duct diameter ≥10 mm） is more likely to develop PEP than nondilated patient （bile duct diameter < 10 mm）. Therefore, ERCP + EST + ENBD should be carefully handled in these patients, and complex endoscopic surgical operations should be avoided as far as possible.
- Endoscopic retrograde cholangiopancreatography,
- Biliary dilatation,
- Bile duct uneven dilatation,
- ERCP,
- Post-ERCP pancreatitis,
- Anomalous pancreaticobiliary ductal junction

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