Qom University of Medical Sciences Journal

Background and Objectives: ERCP is a specific technique, which allows bile and pancreatic duct imaging along with a variety of therapeutic interventions. The complexity of this technique has led to a challenge between its benefits and its serious or even mortal complications, among which, pancreatitis is the most common. The aim of this study was to assess the incidence, risk factors, and protective factors of this complication.

Methods: In this cross-sectional study, the research population was 310 individuals who referred to Gastroenterology and Hepatology Research Centre of Qom city. At the beginning of the study, demographic characteristics, medical history, and necessary laboratory results of the participants, were recorded and then they underwent ERCP. After 6 hours, physical examination was performed and serum amylase level was evaluated. Six hours after the procedure, the results of examination and amylase test were recorded. Data were analyzed using non-parametric Chi-square and parametric paired t-test.

Results: The incidence of pancreatitis was 8.1% and mortality rate was 0.9%; %34 of the patients had hyperamylasemia. Cannulation was difficult, and the number of pancreatic duct cannulation was reported as a risk factor. The mean serum amylase level after ERCP, showed a significant increase in patients with pancreatitis.

Conclusion: In this study, the incidence of pancreatitis was 8.1% and the mortality rate was 0.9%, which were similar to previous studies, but the protective role of pancreatic duct stenting was not confirmed. Also, pancreatic duct cannulation and its multiplicity was obvious risk factors. The serum amylase level had a definite association with clinical pancreatitis. More experience of endoscopist and improvement of device function reduced the risk of pancreatitis. Therefore, the serum level of amylase is a reliable factor for diagnosis of this complication.