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Medline ® Abstract for Reference 39

of 'Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis'

Are drugs a risk factor of post-ERCP pancreatitis?
Perney P, Berthier E, Pageaux GP, Hillaire-Buys D, Roques V, Fabbro-Peray P, Melki M, Hanslik B, Bauret P, Larrey D, Blayac JP, Blanc F
Gastrointest Endosc. 2003;58(5):696.
BACKGROUND: Pancreatitis is the most severe complication of ERCP. The aim of this study was to assess whether the use of potentially pancreatotoxic drugs is a risk factor for post-ERCP pancreatitis.
METHODS: Risk factors for post-ERCP pancreatitis and all drugs taken during the month before ERCP were recorded retrospectively in a database. Patients with other causes of acute pancreatitis or chronic pancreatitis were excluded from the analysis. Post-ERCP pancreatitis was defined as abdominal pain and/or vomiting associated with amylase/lipase plasma levels equal to or greater than twice the upper normal value.
RESULTS: A total of 173 patients (95 men, 78 women; mean age, 68 [16]years) were included. Post-ERCP pancreatitis occurred in 31 patients (18%). Several risk factors were identified in a multivariate analysis: difficulty in cannulation (p<0.001), endoscopic sphincterotomy (p<0.005), and female gender (p=0.02). Having taken potent pancreatotoxic drugs increased the occurrence of post-ERCP pancreatitis: odds ratio 3.7: 95% confidence intervals [1.1,12.4], p=0.04.
CONCLUSIONS: Use of pancreatotoxic drugs before or during ERCP significantly increased the risk of post-ERCP pancreatitis. Thus, discontinuation of the use of such drugs before ERCP seems justified whenever possible.
Service de Médecine Interne E, Service d'Hépato-Gastroentérologie, Hôpital Saint Eloi, Montpellier Cedex 5, Montpellier, France.