Post-ERCP pancreatitis in patients with type 2 diabetes mellitus

Miguel‐Yanes, José M. de; García-Cano, Jesús; Jiménez-García, Rodrigo; López‐de‐Andrés, Ana

doi:10.1016/j.gie.2017.08.035

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…On the other hand, other studies found that the incidence of post-ERCP pancreatitis decreases in diabetic patients. This was explained by the presence of chronic pancreatitis and intrinsic gland fibrosis in diabetic patients which act as a protective factor against the development of pancreatitis [16,17]. On the other hand, we did not find any significant correlation between the development of post-ERCP pancreatitis and systemic hypertension among our patients, however, we found that systemic hypertension was higher in patients with post-ERCP pancreatitis.…”

Section: Discussioncontrasting

confidence: 79%

Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients

Shehta¹,

Elshobari²,

Salah³

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Objectives Endoscopic retrograde cholangiopancreatography (ERCP) has shown great safety and efficacy in the management of post-living-donor liver transplantation (LDLT) biliary complications. Pancreatitis is the most commonest and the most feared complication after ERCP. Methods We reviewed the data of liver transplant recipients who underwent ERCP for biliary complications after LDLT between 2011 and 2022. Results In total 63 patients underwent ERCP after LDLT. They were targeted to 134 set of ERCP. Pancreatitis occurred in 52 sets (38.8%). We subclassified the patients into two groups, without pancreatitis: 31 patients (49.2%) and with pancreatitis 32 patients (50.8%). A higher incidence of pancreatitis was noticed with the first ERCP set (P = 0.04). Biliary strictures were more noted in the pancreatitis group (P = 0.025). Difficult cannulation requiring precut was more observed in the pancreatitis group (P = 0.007). Also, more frequent sphincterotomy was observed in the pancreatitis group (P = 0.003). Longer hospital stay, more fever, abdominal pain and vomiting were noted in the pancreatitis group (P = 0.001). Higher post-ERCP serum amylase (P = 0.001) and creatinine (P = 0.021), while lower serum calcium (P = 0.21) were noticed in the pancreatitis group. On multivariate analysis, preoperative diabetes, number of biliary anastomoses (single/multiple) and difficult cannulation requiring precut were significant predictors of post-ERCP pancreatitis. Conclusion Patient-related risk factors and bedside procedure-related risk factors play an essential role in the development of pancreatitis after ERCP for LDLT recipients. Endoscopists should be mindful by those high-risk patients during ERCP to apply appropriate techniques to prevent the development of this serious complication.

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Section: Discussioncontrasting

confidence: 79%

Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients

Shehta¹,

Elshobari²,

Salah³

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Machine learning for the prediction of post-ERCP pancreatitis risk: A proof-of-concept study

Ciarfaglia

Cárdenas-Jaén

Poropat

et al. 2023

Digestive and Liver Disease

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Response:

Liao

Qian

Zhao

et al. 2018

Gastrointestinal Endoscopy

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In their recent observational study, Zhao et al 1 found similar incidence rates of post-ERCP pancreatitis (PEP) in patients with chronic pancreatitis (CP) versus other biliary diseases, and they reported lower PEP incidence rates as the severity of CP increased. The authors state that they "identified other possible risk and protective factors not examined before. The reduced incidence of PEP in CP patients was correlated with the presence of diabetes mellitus, pancreatic stones, and the use of ESWL (extracorporeal shock wave lithotripsy)." We would like to point out that our group had formerly evaluated the influence of type 2 diabetes mellitus (T2DM) on the short-term adverse events after ERCP in an 11-year (2003-2013) observational study that included 126,885 therapeutic procedures (23,002 [18.1%] in people with T2DM) in the overall Spanish population. 2 We found lower crude incidence rates of PEP in people with T2DM than in people without T2DM (15.9% vs 18.3%, respectively). We additionally described decreasing numbers of PEP over time, but this trend reached statistical significance only for people without T2DM. In our study, T2DM was associated with lower in-hospital mortality after an endoscopic biliary sphincterotomy (odds ratio [OR] Z 0.82 [0.74-0.92]). Last, time trend analyses from 2003 to 2013 showed significant reductions in in-hospital mortality over time only in people with T2DM (OR Z 0.97 [0.94-1.00]). Despite some methodologic limitations inherent in observational studies, we believe that it is worth remembering our results at this point. 3 DISCLOSURE All authors disclosed no financial relationships relevant to this publication.

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Post-ERCP pancreatitis in patients with type 2 diabetes mellitus

Cited by 3 publications

References 3 publications

Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients

Predictive factors of postendoscopic retrograde cholangiopancreatography pancreatitis for biliary complications in living-donor liver transplantation recipients

Machine learning for the prediction of post-ERCP pancreatitis risk: A proof-of-concept study

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