114 Predictors of Post-ERCP Pancreatitis: Analysis of a 3323-Case Cohort from a UK Hospital's Surgeon-Led Service

Abstract Aim Pancreatitis is a recognised and detrimental outcome of Endoscopic Retrograde Cholangio-Pancreatography (PEP), with specific contributing risk factors suggested. Better understanding of these factors could facilitate personalized risk assessment models, minimise PEP incidence, and improve ERCP safety. This study was carried out to identify patients at risk and improve on quality. Method A collection of data over a 9-year period of 3323 cases by UGI surgeon endoscopists was collated. 2.74% were diagnosed with PEP, and specific indices were analysed via univariate and multivariate modalities to assess relationship with PEP risk, and the results were expressed as odds ratio (OR), with 95% confidence interval (CI), and p-value for statistical relevance. Results On univariate analysis; urgency of procedure (OR=3.461; 95% CI=2.12-5.68), first ERCP (OR=5.19; 95% CI=2.98-9.83), age <60years (OR=1.64; 95% CI=1.05-2.51) and stent placement (OR=1.58; 95% CI=1.03-2.41) were associated with statistically significant increased risk of PEP, with consistent results on multivariate analysis. However, in our cohort, female gender (OR= 1.27, 95% CI=0.82-1.96), brushings taken during procedure (OR=1.53; 95% CI=0.67-3.02) and stone disease as indication (OR=1.02; 95% CI=0.65-1.65) depicted slightly increased risk, without reaching statistical significance. Furthermore, the performing surgical endoscopist (i.e. operator influence) had no relationship with incidence of PEP among our patients. Conclusions An urgent procedure as a first-time ERCP, in a young patient and stent placement significantly increases the risk of PEP. Personalized risk assessments based on identified key factors can enhance ERCP safety and suggest most appropriate alternatives.