Endoscopic Management of Biliary Complications after Orthotopic Liver Transplantation

AIMS: To investigate whether any patient ctmracteristics or technical maneuvers are i-elated to acute pancreatitis following ERCP.METHODS: Starting from June 1995 to December 1996 the data related to 1030 consecutive patients which underwent ERCP were collected using a association with acute pancreatitis of continuous and categorical variables standardized database.The General Linear Model and ;(2 test were used to test the statistical.PATIENTS: Mean age was 73 4. 25.3; 451 men and 579 women.The patients cannulated were 935 (91%), with 647 (63 %) sphyncterotomies; in 150 (15 %) a needle-knife papillothomy was performed to enter the common bile duct.Acute pancreatitis was defined as a clinical syndrome of abdominal pain and increased amylasemia detected with a 5 days prospective follow-up after ERCP.RESULTS: Acute pancreatitis was diagnosed in 25 (2.4 %) patients.Amylasemia before ERCP, previous episodes of acute pancreatitis, duodenal diverticula, Oddi's morphological aspect, bilio-pancreatic pathology, age and sex were not associated to acute pancreatitis.Wirsung cannulation, needleknife papillothomy, sphincterotomy, repeated attempts to cannulate bile ducts, dilatation of biliary tree were not associated to acute pancreatitis.Widening of a previous sphincterotomy was the only technical maneuver associated to pancreatitis (Z 2 p=0.001) with an estimated relative risk of 7.4.DISCUSSION: In a referral Centre for ERCP with a very low incidence of complications, patients characteristics and technical maneuvers are not predictive of acute pancreatitis.