ERCP-induced acute necrotizing pancreatitis: Is it a more severe disease?

Anthony S.Y. Fung, Gregory G. Tsiotos, Michael G. Sarr

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Acute necrotizing pancreatitis (AMP) is an uncommon but serious complication of endoscopic retrograde cholangiopancreatography (ERCP). This study compares the severity, clinical course, and long-term outcome of ERCP- induced ANP with AMP induced by other causes. A review of 72 consecutive patients with ANP treated surgically at the Mayo Clinic identified ERCP as the cause in 6 patients (8%). Compared to the remaining 66 patients, the post-ERCP group had higher APACHE II scores on admission (mean, 13 vs. 10) and more extensive pancreatic necrosis (mean, 55 vs. 47%). The post-ERCP group had a higher rate of infected necrosis (100 vs. 75%) and required earlier neurosectomy after the onset of pancreatitis (9 vs. 13 days). The rate of postoperative pancreatic and enteric fistulae was also higher (50 vs. 33%). Although the mortality rate in the post-ERCP group was lower (17 vs. 29%), they were significantly younger (50 vs. 62 years; p = 0.02) and all the survivors had residual long-term morbidity. ANP is more severe when ERCP- induced; infection introduced during the ERCP may, in part, account for this severity.

Original languageEnglish (US)
Pages (from-to)217-221
Number of pages5
JournalPancreas
Volume15
Issue number3
DOIs
StatePublished - Oct 1997

Keywords

  • Complications
  • Endoscopic retograde cholagiopancreatography
  • Infection
  • Necrotizing pancreatitis
  • Outcome
  • Severity

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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