Personalized prediction of acute pancreatitis after endoscopic transpapillary interventions

Vedenin Yu.I.; Turovets M.I.; Mandrikov V.V.; Mikhailichenko G.V.

doi:https://doi.org/10.17116/hirurgia202501129

Vedenin Yu.I.

Volgograd State Medical University

ORCID: 0000-0001-9004-7694

Turovets M.I.

Volgograd State Medical University

ORCID: 0000-0003-0793-5098

Mandrikov V.V.

Volgograd State Medical University

ORCID: 0000-0002-5890-8500

Mikhailichenko G.V.

Volgograd State Medical University

ORCID: 0000-0002-8938-3559

Personalized prediction of acute pancreatitis after endoscopic transpapillary interventions

Authors:

Vedenin Yu.I., Turovets M.I., Mandrikov V.V., Mikhailichenko G.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(1): 29‑36

DOI: 10.17116/hirurgia202501129

Read: 827 times

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To cite this article:

Vedenin YuI, Turovets MI, Mandrikov VV, Mikhailichenko GV. Personalized prediction of acute pancreatitis after endoscopic transpapillary interventions. Pirogov Russian Journal of Surgery. 2025;(1):29‑36. (In Russ.)
https://doi.org/10.17116/hirurgia202501129

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To develop the personalized model for predicting the risk of acute pancreatitis after endoscopic transpapillary interventions.

MATERIAL AND METHODS

A retrospective analysis of treatment outcomes included 366 patients with benign and malignant pancreaticobiliary diseases who underwent endoscopic transpapillary interventions. Risk factors associated with patients, underlying diseases and interventions were analyzed. Logistic regression analysis was used to present the personalized model for predicting the risk of acute pancreatitis.

RESULTS

Female gender (p=0.028), age <40 years (p=0.001—0.018), calculous cholecystitis (p=0.010) and stenosis of the major duodenal papilla (p=0.008) are patient-associated risk factors of acute postoperative pancreatitis. Stenting of the main pancreatic duct and thoracic epidural analgesia reduced this risk by 6.5 and 4.6 times, respectively. We developed significant (p<0.001) regression model to determine the likelihood of acute post-manipulation pancreatitis.

CONCLUSION

Original prediction model is valuable to determine the risk of acute pancreatitis after endoscopic transpapillary interventions. This model justifies various methods to prevent this complication.

Keywords:

acute post-manipulation pancreatitis

endoscopic transpapillary intervention

predicting the risk of acute post-manipulation pancreatitis

stenting of the main pancreatic duct

thoracic epidural analgesia

Authors:

Vedenin Yu.I.

Volgograd State Medical University

ORCID: 0000-0001-9004-7694

Turovets M.I.

Volgograd State Medical University

ORCID: 0000-0003-0793-5098

Mandrikov V.V.

Volgograd State Medical University

ORCID: 0000-0002-5890-8500

Mikhailichenko G.V.

Volgograd State Medical University

ORCID: 0000-0002-8938-3559

Received:

17.03.2024

Accepted:

10.04.2024

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References:

Frolov PA, Korotkevich AG, Pavlenko VV, Pachgin IV, Krasnov KA. Prevention of acute post-manipulation pancreatitis. Experimental and Clinical Gastroenterology. 2023;5(213):114-121. (In Russ.). https://doi.org/10.31146/1682-8658-ecg-213-5-114-121
Klimova NV, Ilkanich AYa, Darvin VV, Koctrubin AL, Vardanyan TS, Aliev FS. Radiation study techniques in diagnosing the causes of opisthorchiasis-induced obstructive jaundice. Journal of radiology and nuclear medicine. 2020;101(1):39-46. (In Russ.). https://doi.org/10.20862/0042-4676-2020-101-1-39-46
Shapovolyants SG, Gabriel SA, Dynko VYu, Kotieva AYu, Mamishev AK, Bespechny MV. Acute post-manipulation pancreatitis: diagnosis, risk factors, methods of prevention. Endoscopic Surgery. 2020;26(4):49-53. (In Russ.). https://doi.org/10.17116/endoskop20202604149
Ang TL. Mitigating the risk of post-ERCP pancreatitis: Science and clinical practice. Journal of Gastroenterology and Hepatology. 2020;35(5):703-704. https://doi.org/10.1111/jgh.15038
Dumonceau JM, Kapral C, Aabakken L, Papanikolaou IS, Tringali A, Vanbiervliet G, Beyna T, Dinis-Ribeiro M, Hritz I, Mariani A, Paspatis G, Radaelli F, Lakhtakia S, Veitch AM, van Hooft JE. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020;52(2):127-149. https://doi.org/10.1055/a-1075-4080
Chen PH, Tung CF, Peng YC, Yeh HZ, Chang CS, Chen CC. Duodenal major papilla morphology can affect biliary cannulation and complications during ERCP, an observational study. BMC Gastroenterology. 2020;20(1):310. https://doi.org/10.1186/s12876-020-01455-0
Phillip V, Pukitis A, Epstein A, Hapfelmeier A, Haf D, Schwab M, Demir IE, Rosendahl J, Hoffmeister A, Schmid RM, Weber A, Algül H. Pancreatic stenting to prevent post-ERCP pancreatitis: a randomized multicenter trial. Endoscopy International Open. 2019;7(7):E860-E868. https://doi.org/10.1055/a-0886-6384
Styazhkina SN, Spiridonov TR, Novikova ED, Eltsov TO. Peculiarities of pharmacological prevention strategy of pancreatic complications after endoscopic papillosphincterotomy for choledocholithiasis. Medical alphabet. 2023;(28):19-22. (In Russ.). https://doi.org/10.33667/2078-5631-2023-28-19-22
Park CH, Park SW, Yang MJ, Moon SH, Park DH. Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis. Surgical Endoscopy. 2022;36(3):2052-2061. https://doi.org/10.1007/s00464-021-08491-1
Buxbaum JL, Freeman M, Amateau SK, Chalhoub JM, Coelho-Prabhu N, Desai M, Elhanafi SE, Forbes N, Fujii-Lau LL, Kohli DR, Kwon RS, Machicado JD, Marya NB, Pawa S, Ruan WH, Sheth SG, Thiruvengadam NR, Thosani NC, Qumseya BJ (ASGE Standards of Practice Committee Chair). American Society for Gastrointestinal Endoscopy guideline on post-ERCP pancreatitis prevention strategies: summary and recommendations. Gastrointestinal Endoscopy. 2023;97(2):153-162. https://doi.org/10.1016/j.gie.2022.10.005
Deviere J. Post-ERCP pancreatitis: still a major issue despite all efforts. Endoscopy. 2021;53:367.
Parvin S, Islam MS, Azam MG, Majumdar TK, Ahmed S, Zaman T, Dutta R. Role of 4-H Serum Lipase Level in Predicting Postendoscopic retrograde Cholangiopancreatography Pancreatitis. International Journal of Applied and Basic Medical Research. 2021;11(4):238-242. https://doi.org/10.4103/ijabmr.ijabmr_192_21
Tyagi A, Gupta YR, Das S, Rai G, Gupta A. Effect of Segmental Thoracic Epidural Block on Pancreatitisinduced Organ Dysfunction: A Preliminary Study. Indian Journal of Critical Care Medicine. 2019;23(2):89-94. https://doi.org/10.5005/jp-journals-10071-23123
Ergin E, Oruç N, Ersöz G, Tekeşin O, Özütemiz Ö. Prognosis and risk factors of ERCP pancreatitis in elderly. Scientific Reports. 2021;11(1):15930. https://doi.org/10.1038/s41598-021-95484-8
Fujita K, Yazumi S, Uza N, Kurita A, Asada M, Kodama Y, Goto M, Katayama T, Anami T, Watanabe A, Sugahara A, Mukai H, Kawamura T. New practical scoring system to predict post-endoscopic retrograde cholangiopancreatography pancreatitis: Development and validation. JGH Open. 2021;5(9):1078-1084. https://doi.org/10.1002/jgh3.12634
Boicean A, Birlutiu V, Ichim C, Todor SB, Hasegan A, Bacila C, Solomon A, Cristian A, Dura H. Predictors of Post-ERCP Pancreatitis (P.E.P.) in Choledochal Lithiasis Extraction. Journal of Personalized Medicine. 2023;13(9):1356. https://doi.org/10.3390/jpm13091356