Brushing the distal biliary stricture in the surrounding of the papilla increased the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis: A retrospective study using propensity score analysis. Issue 7 (November 2017)

• Record Type: Journal Article
• Authors: Kato, Kunihiro; Sugimori, Satoshi; Kakiya, Yuki; Maruyama, Hirotsugu; Fukunaga, Shusei; Nagami, Yasuaki; Shiba, Masatsugu; Tanigawa, Tetsuya; Watanabe, Toshio; Fujiwara, Yasuhiro
• Is Part Of: United European Gastroenterology journal. Volume 5:Issue 7(2017)
• Page Start: 1015
• Page End: 1023
• Publication Date: 2017-11
• Subjects: Post-endoscopic retrograde cholangiopancreatography pancreatitis -- risk factor -- biliary brushing cytology -- propensity score -- inverse probability of treatment weighting; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640617694279
• Languages: English
• ISSNs: 2050-6406

Abstract

Background and aims: Brushing cytology is useful for diagnosing biliary strictures. With regard to biliary stricture brushing at the distal common bile duct in the surrounding of the papilla, the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis is unknown. Our study aimed to evaluate the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis by using this procedure. Methods: A total of 150 endoscopic retrograde cholangiopancreatography-naïve patients undergoing endoscopic retrograde cholangiopancreatography including biliary stricture brushing were retrospectively analyzed. Patients were divided into two groups: the surrounding of the papilla group ( n = 25) and the other group ( n = 125). The primary outcome was the post-endoscopic retrograde cholangiopancreatography pancreatitis incidence. We analyzed the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis by using inverse probability of treatment weighting based on propensity scores to adjust for selection bias. Results: The overall incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis was 11.3%, and post-endoscopic retrograde cholangiopancreatography pancreatitis of the surrounding of the papilla group occurred significantly more frequently than in the other group (32.0% vs 7.2%, p < 0.01). Multivariate analysis showed that this procedure was a risk factor for post-endoscopic retrograde cholangiopancreatography pancreatitis (odds ratio, 10.6; 95% confidence interval, 2.82–40.2; p < 0.01). In the propensity-weighted model, this procedure was an independent risk factor for post-endoscopic retrograde cholangiopancreatography pancreatitis (odds ratio, 8.42; 95% confidence interval, 2.12–32.4; p < 0.01) by multivariate analysis. Conclusions: Biliary stricture brushing at the distal common bile duct in the surrounding of the papilla may increase the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis compared with brushing other portions.