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Impact of pancreatic fat on the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis

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Abstract

Background and study aims

Fatty pancreas is a potential risk factor for acute pancreatitis; however, whether it is also a risk factor for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) has not been evaluated. We aimed to determine the impact of fatty pancreas on the development of PEP.

Methods

We analyzed the data of patients who underwent abdominal computed tomography (CT) scan and sequential therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Fatty change in the pancreas was evaluated based on pancreatic attenuation of unenhanced image on CT scan. The risk of fatty pancreas for the development of PEP was evaluated using a logistic regression model.

Results

Of a total of 858 patients included in the study, 354 (41.3%) had fatty pancreas, while 504 (58.7%) did not have fatty pancreas. PEP developed in 28 patients (7.9%) in the fatty pancreas group and in 13 patients (2.6%) in the no fatty pancreas group. Fatty pancreas was significantly associated with the development of PEP (odds ratio [OR] [95% confidence interval [CI]] 2.38 [1.16–4.87]). A history of acute pancreatitis, female sex, difficult cannulation, and endoscopic papillary balloon dilation were also risk factors for the development of PEP. The risk for moderate-to-severe PEP development tended to be higher in the fatty pancreas group than in the no fatty pancreas group (OR [95% CI] 5.61 [0.63–49.62]).

Conclusions

Fatty pancreas is a significant risk factor for the development of PEP. Clinicians need to be aware of the risk of fatty pancreas for the development of PEP prior to performing ERCP.

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Funding

This research was supported by Hallym University Research Fund 2020 (HURF-2020-55).

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Author notes

  1. Chan Hyuk Park and Moon Jae Chung have contributed equally as first authors.

Authors and Affiliations

  1. Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Republic of Korea

    Chan Hyuk Park

  2. Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Moon Jae Chung

  3. Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea

    Da Hae Park & Se Woo Park

  4. Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea

    Seonjeong Min

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Contributions

Guarantor of the article: SWP. SWP conceived and designed the study. MJC and SWP provided study materials or patients. CHP, MJC, DHP, SM, and SWP analyzed and interpreted the data. SWP and CHP drafted the article. SWP, SM, and CHP critically revised the article for important intellectual content. CHP performed the statistical analyses. All authors were responsible for conducting the study, including care of the patients, acquisition of the data, and interpretation of the data after analysis. After drafting of the initial manuscript, all authors critically revised the manuscript and approved the final version.

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Correspondence to Se Woo Park.

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Chan Hyuk Park, Moon Jae Chung, Da Hae Park, Seonjeong Min, and Se Woo Park have no conflicts of interest or financial ties to disclose.

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Park, C.H., Chung, M.J., Park, D.H. et al. Impact of pancreatic fat on the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. Surg Endosc 36, 5734–5742 (2022). https://doi.org/10.1007/s00464-022-09070-8

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  • DOI: https://doi.org/10.1007/s00464-022-09070-8

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