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Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction

In the present era, post-ERCP pancreatitis (PEP) stands out as one of the most commonly occurring complications associated with endoscopic choledochal lithiasis extraction. The ability to predict the occurrence of such an event, particularly by utilizing absolute values and ratio dynamics of the eme...

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Autores principales: Boicean, Adrian, Birlutiu, Victoria, Ichim, Cristian, Todor, Samuel B., Hasegan, Adrian, Bacila, Ciprian, Solomon, Adelaida, Cristian, Adrian, Dura, Horatiu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532909/
https://www.ncbi.nlm.nih.gov/pubmed/37763124
http://dx.doi.org/10.3390/jpm13091356
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author Boicean, Adrian
Birlutiu, Victoria
Ichim, Cristian
Todor, Samuel B.
Hasegan, Adrian
Bacila, Ciprian
Solomon, Adelaida
Cristian, Adrian
Dura, Horatiu
author_facet Boicean, Adrian
Birlutiu, Victoria
Ichim, Cristian
Todor, Samuel B.
Hasegan, Adrian
Bacila, Ciprian
Solomon, Adelaida
Cristian, Adrian
Dura, Horatiu
author_sort Boicean, Adrian
collection PubMed
description In the present era, post-ERCP pancreatitis (PEP) stands out as one of the most commonly occurring complications associated with endoscopic choledochal lithiasis extraction. The ability to predict the occurrence of such an event, particularly by utilizing absolute values and ratio dynamics of the emergency blood tests, constitutes the primary step in effectively managing a patient with a complex pathology. The study involved 134 patients who performed ERCP to extract choledochal lithiasis (n = 48 with PEP and n = 86 without PEP). The results revealed increased risks of post-ERCP pancreatitis in women and lower risks in those who benefited from manipulation of the main bile duct with the Dormia probe and dilatation balloon (OR: 2.893 CI 95%: 1.371–6.105, p = 0.005 and respectively OR: 0.346 CI 95%: 0.156–0.765, p = 0.009), without biliary stent placement. Moreover, the results brought novel elements to the literature, showing that higher values of CRPR (OR: 4.337 CI 95%: 1.945–9.668; p < 0.001), TBIR (4.004 CI 95%: 1.664–9.634; p = 0.002) and NLR post-ERCP (3.281 CI 95%: 1.490–7.221; p = 0.003) are predictive for PEP. Nevertheless, lower total bilirubin levels upon admission are predictive of PEP with an OR of 5.262 (95% confidence interval: 2.111–13.113, p < 0.001).
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spelling pubmed-105329092023-09-28 Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction Boicean, Adrian Birlutiu, Victoria Ichim, Cristian Todor, Samuel B. Hasegan, Adrian Bacila, Ciprian Solomon, Adelaida Cristian, Adrian Dura, Horatiu J Pers Med Article In the present era, post-ERCP pancreatitis (PEP) stands out as one of the most commonly occurring complications associated with endoscopic choledochal lithiasis extraction. The ability to predict the occurrence of such an event, particularly by utilizing absolute values and ratio dynamics of the emergency blood tests, constitutes the primary step in effectively managing a patient with a complex pathology. The study involved 134 patients who performed ERCP to extract choledochal lithiasis (n = 48 with PEP and n = 86 without PEP). The results revealed increased risks of post-ERCP pancreatitis in women and lower risks in those who benefited from manipulation of the main bile duct with the Dormia probe and dilatation balloon (OR: 2.893 CI 95%: 1.371–6.105, p = 0.005 and respectively OR: 0.346 CI 95%: 0.156–0.765, p = 0.009), without biliary stent placement. Moreover, the results brought novel elements to the literature, showing that higher values of CRPR (OR: 4.337 CI 95%: 1.945–9.668; p < 0.001), TBIR (4.004 CI 95%: 1.664–9.634; p = 0.002) and NLR post-ERCP (3.281 CI 95%: 1.490–7.221; p = 0.003) are predictive for PEP. Nevertheless, lower total bilirubin levels upon admission are predictive of PEP with an OR of 5.262 (95% confidence interval: 2.111–13.113, p < 0.001). MDPI 2023-09-05 /pmc/articles/PMC10532909/ /pubmed/37763124 http://dx.doi.org/10.3390/jpm13091356 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Boicean, Adrian
Birlutiu, Victoria
Ichim, Cristian
Todor, Samuel B.
Hasegan, Adrian
Bacila, Ciprian
Solomon, Adelaida
Cristian, Adrian
Dura, Horatiu
Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title_full Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title_fullStr Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title_full_unstemmed Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title_short Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction
title_sort predictors of post-ercp pancreatitis (p.e.p.) in choledochal lithiasis extraction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532909/
https://www.ncbi.nlm.nih.gov/pubmed/37763124
http://dx.doi.org/10.3390/jpm13091356
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