Effects of Medications on Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis |
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Authors: | N. Li A. Tieng S. Novak A. Fernandes P.K. Jalal M. Akerman K. Sideridis S. Bank |
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Affiliation: | 1. Departments of Medicine, Long Island Jewish Medical Center, New Hyde Park, N.Y.;2. Departments of Gastroenterology, Long Island Jewish Medical Center, New Hyde Park, N.Y.;3. Departments of Biostatistics Unit, The Feinstein Institute for Medical Research, Manhasset, N.Y., USA;1. Department of Pediatric Hemato-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium;2. Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium;3. School of Life Sciences, Hasselt University, Hasselt, Belgium;4. Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium;1. Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia;3. Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia;4. Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia;1. Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA;2. Division of Gastroenterology, Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA;3. Division of Gastroenterology, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA;4. Division of Gastroenterology, Department of Internal Medicine, Saint Peter''s University Hospital/Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, USA;5. Division of Gastroenterology, Department of Internal Medicine, Mayo Clinic, Florida, USA |
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Abstract: | Background and Aims: Drug-induced pancreatitis accounts for about 2% of acute pancreatitis. The aim of this study is to determine whether propofol and other medications are associated with increased risk for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Methods: A retrospective study was conducted at a single tertiary care hospital. All patients who underwent ERCP from 2001 to 2004 were included. Diagnosis of acute post-ERCP pancreatitis was based on a consensus definition. Results: A total of 506 patients underwent ERCP. The total incidence of post-ERCP pancreatitis was 7.1%. There was no significant difference in post-ERCP pancreatitis between patients who received propofol compared to patients who received midazolam and fentanyl (9.0 vs. 5.9%, p = 0.18). Patients receiving an angiotensin receptor blocker were approximately 4 times more likely to develop post-ERCP pancreatitis (OR = 4.1, 95% CI 1.6–10.9). Patients younger than 65 years and smokers also had higher risk of developing acute post-ERCP pancreatitis than those who were older than 65 years (OR = 3.9, 95% CI 1.7–9.1) and non-smokers (OR = 2.8, 95% CI 1.3–6.2). Conclusions: Propofol is a safe sedative drug for ERCP without additional risk of developing acute post-ERCP pancreatitis. Use of angiotensin receptor blockers, smoking and younger age are independent risk factors for post-ERCP pancreatitis. |
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