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- W2913792920 abstract "Introduction: Endotherapy on the minor papilla is a technically challenging procedure with significant potential complications. Data on Post-ERCP Pancreatitis (PEP) in patients with pancreas divisum undergoing minor papilla intervention is variable and limited. This study aimed to assess risk factors associated with PEP in this unique population. Methods: All patients with pancreatic divisum who developed PEP after therapeutic endotherapy on minor papilla from April 2009 to November 2016 were included in this retrospective case control study. Control group of interventions, procedural complexity, endoscopist, and year performed-matched procedures without PEP in 2:1 match ratio were compared using bivariate analysis. Results: Among 174 ERCP performed for patients with pancreas divisum during study period, 5.17% had PEP. 9 ERCPs with PEP performed in 8 patients with pancreas divisum and 18 matchedprocedures without PEP performed in 18 patients were analyzed. All procedures were ASGE complexity category 3. In the PEP group, 8 (89%) were male, 6 (67%) were Caucasian, 7 (78%) had complete divisum, and the mean age was 37.8+/-16.1 years old. Regarding endoscopic intervention, 4 (44%) had minor papillotomy with stent placement, 2 (22%) had unsuccessful cannulation, 1 (11%) had stent exchange, 1 (11%) underwent epinephrine injection and argon plasma coagulation for post papillotomy bleeding, and 1 (11%) had stent extraction. 2.3%, 1.7%, and 1.1% had mild, moderate, and severe PEP, respectively with mean hospitalization of 6.8+/-4.1 days. Compared with the non-PEP group, indomethacin use was significantly lower (x2=5.85; P=0.01). After adjusting for indomethacin use in post-hoc analysis, smoking and chronic opioid use were significantly more common in the PEP group (x2=3.7; P=0.05 and x2=10.4; P=0.001). There was no statistically significant difference in age, gender, ethnicity, complete or partial divisum, or native papilla (P=0.08, 1.0, 0.72, 0.76, 0.59, respectively). Conclusion: Patients with pancreas divisum undergoing minor papilla intervention had a low rate of PEP in this cohort. Smoking and chronic opioid use were associated with increased risk, while indomethacin appeared to be protective. Even in a small single institution study, there appeared to be heterogeneity in the endoscopic approach for minor papilla therapeutic intervention." @default.
- W2913792920 created "2019-02-21" @default.
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- W2913792920 date "2017-10-01" @default.
- W2913792920 modified "2023-09-25" @default.
- W2913792920 title "Post-ERCP Pancreatitis After Minor Papilla Intervention in Pancreas Divisum: The Incidence, the Risk, and Prevention" @default.
- W2913792920 doi "https://doi.org/10.14309/00000434-201710001-00062" @default.
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