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 journalArticle

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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