Higher Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Patients With Asymptomatic Common Bile Duct Stones Compared to Symptomatic Cases: A Propensity Score-Matched Cohort Analysis.

IF 2.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-06-24 DOI:10.1002/jhbp.12178

Fumiya Kataoka, Mitsuru Okuno, Tsuyoshi Mukai, Atsushi Tagami, Hiroshi Araki, Junichi Sugihara, Eiichi Tomita, Hisataka Moriwaki, Atsushi Masamune, Masahito Shimizu

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引用次数: 0

Abstract

Background and aims: Endoscopic retrograde cholangiopancreatography (ERCP), the standard procedure for common bile duct (CBD) stones (CBDS) removal, carries a risk of post-ERCP pancreatitis (PEP). We compared PEP-related factors between asymptomatic and symptomatic CBDS cases.

Methods: A retrospective cohort study was conducted on 367 patients who underwent ERCP for CBDS. To adjust for baseline differences, propensity score matching (PSM) was performed, yielding 170 matched patients (85 asymptomatic and 85 symptomatic groups) for comparative analysis of PEP-related factors.

Results: Baseline differences in the proportion of patients with American Society of Anesthesiologists-Physical Status (≥ 3) cases, CBD diameter, and CBDS size were eliminated after PSM. The asymptomatic group had a significantly longer ERCP procedure time (20 vs. 18-min, p = 0.02) and a higher incidence of PEP compared to the symptomatic group (11.8% vs. 1.2%, p = 0.01). Multivariate analysis confirmed that asymptomatic CBDS cases (odds ratio [OR]: 9.37, 95% confidence interval [CI]: 1.13-77.6, p = 0.0381) and prolonged procedure time (> 26 min, OR: 5.29, 95% CI: 1.26-22.3, p = 0.0231) were independent risk factors for PEP.

Conclusions: ERCP procedures performed for asymptomatic CBDS cases are associated with a higher risk of PEP. The decision to perform ERCP in asymptomatic CBDS cases should carefully consider the PEP risk factors of the patient.

Trial registration: UMIN000055951.

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无症状胆总管结石患者与有症状患者相比，内镜后逆行胆管造影胰腺炎的风险更高：倾向评分匹配队列分析

背景和目的：内窥镜逆行胆管造影（ERCP）是胆总管（CBD）结石（CBDS）去除的标准程序，有发生ERCP后胰腺炎（PEP）的风险。我们比较无症状和有症状的CBDS患者的pep相关因素。方法：对367例接受ERCP治疗CBDS的患者进行回顾性队列研究。为了调整基线差异，进行倾向评分匹配（PSM），产生170例匹配患者（85例无症状组和85例有症状组），用于pep相关因素的比较分析。结果：PSM后消除了美国麻醉医师协会-身体状况（≥3）病例、CBD直径和CBDS大小的患者比例的基线差异。与有症状组相比，无症状组ERCP手术时间明显更长（20分钟vs 18分钟，p = 0.02）， PEP发生率更高（11.8% vs 1.2%, p = 0.01）。多因素分析证实，无症状CBDS病例（比值比[OR]: 9.37, 95%可信区间[CI]: 1.13-77.6, p = 0.0381）和手术时间延长（比值比[OR]: 5.29, 95% CI: 1.26-22.3, p = 0.0231）是PEP的独立危险因素。结论：无症状CBDS患者行ERCP手术与PEP的高风险相关。在决定对无症状CBDS患者实施ERCP时，应仔细考虑患者PEP的危险因素。试验注册号：UMIN000055951。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.