Iatrogenic pancreatitis in patients with IPMN after ERCP: incidence and predictive signs

• Published in: Abdominal imaging 2014-10, Vol.39 (5), p.949-954
• Main Authors: Jung, Min Kyu, Jang, Yun-Jin, Cho, Chang Min, Kim, Gab Chul, Cho, Seung Hyun, Lee, Dakeun, Ryeom, Hun Kyu, Shin, Kyung Min
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - diagnostic imaging; Adenocarcinoma, Mucinous - epidemiology; Adult; Aged; Aged, 80 and over; Carcinoma, Pancreatic Ductal - diagnostic imaging; Carcinoma, Pancreatic Ductal - epidemiology; Cholangiopancreatography, Endoscopic Retrograde - methods; Female; Gastroenterology; Hepatology; Humans; Iatrogenic Disease - epidemiology; Imaging; Incidence; Male; Medicine; Medicine & Public Health; Middle Aged; Pancreatic Ducts - diagnostic imaging; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - epidemiology; Pancreatitis - diagnostic imaging; Pancreatitis - epidemiology; Predictive Value of Tests; Prevalence; Radiology
• ISSN: 0942-8925; 2366-004X; 1432-0509; 2366-0058
• DOI: 10.1007/s00261-014-0122-0

Background and aims The prevalence of intraductal papillary mucinous neoplasm (IPMN) has recently increased, and endoscopic retrograde cholangiopancreatography (ERCP) is a major diagnostic modality for IPMN. The aim of our study was to determine the prevalence rate of iatrogenic pancreatitis in the patients with IPMN and the predictive signs on pre-procedural images and endoscopic procedures. Patients and methods At a single center, patients who underwent ERCP between September 2001 and December 2010 were included in this study. The presence of iatrogenic pancreatitis was evaluated and the difference of prevalence in the patients with/without IPMN was determined. Then, a review of cross-sectional images was performed. Results The prevalence rate of iatrogenic pancreatitis in the patients with IPMN was 20% and that in the patients with other pancreatic cystic lesions was 14%. Mural nodules on images and filling defects on ERCP were more highly detected in the patients without iatrogenic pancreatitis ( p  = 0.040 and p  = 0.027, respectively). In the multivariate analysis, the presence of filling defects correlated with a decreased incidence of iatrogenic pancreatitis (odds ratio = 0.119 and p = 0.047). Conclusion In this study, the prevalence rate of ERCP-induced pancreatitis in the patients with IPMN was 21%, and the presence of filling defects was associated with a decreased incidence of iatrogenic pancreatitis.