PMID- 14696407
OWN - NLM
STAT- MEDLINE
DCOM- 20040615
LR  - 20121115
IS  - 0172-6390 (Print)
IS  - 0172-6390 (Linking)
VI  - 50
IP  - 54
DP  - 2003 Nov-Dec
TI  - Risk factors for acute pancreatitis after endoscopic papillary balloon dilation.
PG  - 1796-8
AB  - BACKGROUND/AIMS: Although EPBD (endoscopic papillary balloon dilation) may cause 
      acute pancreatitis, risk factors for post-EPBD pancreatitis have not been well 
      described. We retrospectively analyzed risk factors predictive of acute 
      pancreatitis after EPBD. METHODOLOGY: A total of 101 patients underwent EPBD for 
      choledocholithiasis. Post-EPBD acute pancreatitis was investigated. Nineteen 
      potential risk factors, related to clinical characteristics or procedures, were 
      retrospectively analyzed univariately and multivariately. RESULTS: Bile duct 
      clearance was achieved in 96 patients. Serum amylase was elevated after EPBD in 
      69 patients. Early complications occurred in 11 patients (11%); 5 had minimal 
      (pain persisting for only 12-24 hours) and 6 mild (requiring 1-3 days of 
      treatment) pancreatitis. These 11 patients showed at least a three-fold elevation 
      of serum amylase. Multivariate analysis identified two independent risk factors 
      for pancreatitis (prior history of acute pancreatitis, and bile duct diameter < 
      or = 9 mm). The risk for post-EPBD pancreatitis was not associated with young 
      age, pre-EPBD hyperamylasemia, large or multiple stones, periampullary 
      diverticulum, pancreatic contrast injection, mechanical lithotripsy or residual 
      stones. CONCLUSIONS: Acute pancreatitis, usually mild or minimal, can be 
      anticipated after EPBD for bile duct stones in approximately 10% of patients. In 
      those with previous pancreatitis or a non-dilated bile duct, special care is 
      necessary given the high incidence of pancreatitis.
FAU - Sugiyama, Masanori
AU  - Sugiyama M
AD  - First Department of Surgery, Kyorin University School of Medicine, 6-20-2 
      Shinkawa, Mitaka, Tokyo 181-8611, Japan. sgym@kyorin-u.ac.jp
FAU - Abe, Nobutsugu
AU  - Abe N
FAU - Izumisato, Yumi
AU  - Izumisato Y
FAU - Masaki, Tadahiko
AU  - Masaki T
FAU - Mori, Toshiyuki
AU  - Mori T
FAU - Atomi, Yutaka
AU  - Atomi Y
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Hepatogastroenterology
JT  - Hepato-gastroenterology
JID - 8007849
RN  - EC 3.2.1.- (Amylases)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - *Ampulla of Vater
MH  - Amylases/blood
MH  - Analysis of Variance
MH  - Catheterization/*adverse effects
MH  - Duodenoscopy/*adverse effects
MH  - Female
MH  - Gallstones/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Pancreatitis/*etiology
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2003/12/31 05:00
MHDA- 2004/06/16 05:00
CRDT- 2003/12/31 05:00
PHST- 2003/12/31 05:00 [pubmed]
PHST- 2004/06/16 05:00 [medline]
PHST- 2003/12/31 05:00 [entrez]
PST - ppublish
SO  - Hepatogastroenterology. 2003 Nov-Dec;50(54):1796-8.