Abstract:

Post (ERCP) pancreatitis (PEP) is the most commonly seen complication after endoscopic retrograde cholangio-pancreaticography (ERCP). It is associated with pancreatic hyperamylasemia and persistent abdominal pain. It can be classified as mild, moderate and severe. During ERCP, bile ducts or pancreatic duct can be cannulated using standard sphincteratomy or needle-tipped sphincteratomy methods and contrast material is injected in order to view these ducts. In this study, we aimed to examine whether the use of sphincterotomy methods and pancreatic canal interventions poses a risk in the development of PEP, which is the most common complication after ERCP. Of the 445 patients who underwent ERCP, 270 had standard sphincterotomy and 175 had Needle-knife sphincterotomy (NKS). Patients who were cannulated with pancreatic duct and injected with contrast agent during the procedure and patients who were diagnosed with PEP according to the revised Atlanta criteria, were included in the study. Of 445 patients, 187 were male (39.7%) and 258 were female (60.3%). After successful sphincterotomy, stone extraction basket and / or balloon procedure was applied to all patients. Of the 270 patients, 13(2.9%) patients developed PEP and 9 of these patients had pancreatic duct cannulation and contrast agent injection during the procedure. PEP development was statistically significant in patients with pancreatic duct cannulation (p <0.01). Of 175 patients who underwent NKS, procedure was successful in 168 (96%) patients but 27(6.1%) patients developed PEP. 18 of the patients who developed PEP had pancreatic duct cannulation and contrast material injection. PEP development was statistically significant in patients with pancreatic duct cannulation (p <0.01). We concludedthat the factors increasing the incidence of PEP, which is the most common complication after ERCP are repeated unsuccessful attempts, pancreatic canal entry and contrast agent injection during the procedur. And NKS was found to have higher PEP development compared to standard sphincteratomy

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