Current status and trends in ERCP and post-ERCP pancreatitis in Japan: a nationwide observational study.

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2025-05-02 DOI:10.1007/s00535-025-02254-8

Tomoo Manaka, Tetsuya Takikawa, Kunio Tarasawa, Kazuhiro Kikuta, Ryotaro Matsumoto, Yu Tanaka, Takanori Sano, Shin Hamada, Shin Miura, Kiyoshi Kume, Kenji Fujimori, Kiyohide Fushimi, Atsushi Masamune

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引用次数: 0

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is indispensable for the management of biliary and pancreatic diseases but carries a high risk of post-ERCP pancreatitis (PEP). This study aimed to clarify the current status and temporal trends of ERCP and PEP in Japan, including preventive measures.

Methods: We conducted a retrospective, population-based cohort study using the Diagnosis Procedure Combination database from April 1, 2016, to March 31, 2023. Trend analyses were performed for ERCP, PEP, nonsteroidal anti-inflammatory drugs (NSAIDs), and protease inhibitors. Additionally, factors associated with PEP and severe PEP were evaluated.

Results: Among the 1,073,513 ERCP cases, PEP and severe PEP incidences were 85,212 (7.9%) and 4841 cases (0.5%), respectively. The mortality rate was 0.5% for severe PEP and 0.2% for non-severe cases. The number of ERCP procedures and the proportion of therapeutic ERCP increased over time. The incidence of PEP declined from 9.1% in the fiscal year 2016-2017 to 6.4% in the fiscal year 2022, while the incidence of severe PEP decreased from 0.5 to 0.33% over the same period. The usage rate of rectal NSAIDs increased from 16.4 to 27.6%, whereas that of protease inhibitors decreased from 70.5 to 53.5%. The administration of rectal NSAIDs at doses of 20-25 mg and 50 mg was associated with a reduced risk of severe PEP.

Conclusions: The number of ERCP procedures and the proportion of therapeutic ERCP have increased, whereas the incidences of PEP and severe PEP have decreased. Rectal NSAIDs may prevent the progression of PEP to severe disease.

查看原文本刊更多论文

日本ERCP和ERCP后胰腺炎的现状和趋势：一项全国性的观察性研究。

背景：内镜逆行胰胆管造影（ERCP）对于胆道和胰腺疾病的治疗是必不可少的，但ERCP后胰腺炎（PEP）的风险很高。本研究旨在阐明日本ERCP和PEP的现状和时间趋势，包括预防措施。方法：我们在2016年4月1日至2023年3月31日期间使用诊断程序组合数据库进行了一项回顾性、基于人群的队列研究。对ERCP、PEP、非甾体抗炎药（NSAIDs）和蛋白酶抑制剂进行趋势分析。此外，评估与PEP和严重PEP相关的因素。结果：1,073,513例ERCP中，PEP和重度PEP发生率分别为85,212例（7.9%）和4841例（0.5%）。重症PEP的死亡率为0.5%，非重症病例的死亡率为0.2%。ERCP手术的数量和治疗性ERCP的比例随着时间的推移而增加。PEP的发病率从2016-2017财年的9.1%下降到2022财年的6.4%，而同期严重PEP的发病率从0.5%下降到0.33%。直肠非甾体抗炎药的使用率从16.4%上升到27.6%，蛋白酶抑制剂的使用率从70.5%下降到53.5%。直肠非甾体抗炎药剂量为20- 25mg和50mg与严重PEP风险降低相关。结论：ERCP手术次数和治疗性ERCP的比例有所增加，PEP和严重PEP的发生率有所下降。直肠非甾体抗炎药可以防止PEP发展为严重疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.