The researchers analyzed a prospectively assembled database of 1835 ERCP procedures at a single referral hospital.
Multivariate logistic regression analysis was performed to identify risk factors for pancreatitis and determine their relative contributions.
From these results, a scoring system was constructed.
The performance of the scoring system was assessed on the entire procedure database, and in selected subgroups.
| Scoring system based on 4 post-ERCP pancreatitis risk factors.
| Endoscopy |
Multivariate analysis yielded four risk factors. These were - pain during the procedure, cannulation of the pancreatic duct, previous post-ERCP pancreatitis, and number of cannulation attempts.
The authors developed a scoring system: 4 points for pain, 3 points for pancreatic duct cannulation, 2 points for a history of post-ERCP pancreatitis, and 1-4 points depending on the number of cannulation attempts.
A total score of 1-4 points was associated with a low risk of pancreatitis (< 2%), while a score of 5-8 points had an intermediate risk (7%), and a score of 9 or above had a high risk (28%).
Dr S. Friedland, of Stanford University School of Medicine, Palo Alto, California, said on behalf of fellow authors, "This simple scoring system may enable clinicians to stratify patients into low-risk, medium-risk, and high-risk groups for the development of post-ERCP pancreatitis."
"In addition, when patients with suspected sphincter of Oddi dysfunction and patients who underwent minor papilla cannulation were analyzed separately, the scoring system was able to accurately predict the pancreatitis risk of these patients as well," it was concluded.