Risk Factors for Post-ERCP Cholangitis in Patients with Pancreatic Cancer from a Single Referral Center in Iran

Abstract

Cholangitis is relatively uncommon but associated mortality is high due to the predisposition in people withunderlying disease. For this recognition of contributing risk factors is necessary. Therefore, the present descriptiveanalyticalcross-sectional survey was designed to determine contributing risk factors for post-ERCP cholangitisin patients with pancreatic cancer. From 2005 to 2010, 110 consecutive cases of pancreatic cancer attending to atertiary referral centre (Taleghani Hospital), Tehran, Iran were recruited. The patients all underwent stentingvia endoscopic retrograde cholangiopancreatography (ERCP). On univariate analysis, a metallic stent type(95% confidence interval (CI) 1.025-11.34, P=0.037), having no jaundice (1.44-2.22, P=0.009), having no pain(1.32-1.91, P=0.026), a history of prior ERCP (1.16-10.37, P=0.020), and having a proximal biliary stone (1.002-5.93, P=0.046) were related to cholangitis. However on multivariate analysis, none of these factors were foundto be contributing risk factors. Cholangitis is avoidable with adequate biliary drainage. Because success ratesare higher and complication rates lower for endoscopists performing large volumes of ERCP, performance ofthe procedure should be concentrated as much as possible in institutions with endoscopists having adequateexperience. Patients with a high risk for complications may be best served by referral to an advanced center.