Post-ERCP pancreatitis more likely in elderly women

Elderly women are at a higher risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), a recent study has found. Other risk factors include the sphincter oddi dysfunction (SOD) and juxta papillary diverticula (JPD).

Researchers conducted a retrospective analysis of 2,902 patients who had undergone ERCP procedures between 2008 and 2012. Participants’ demographic, diagnostic, imaging, and biochemical information were included in the analysis, along with ERCP procedural and complication details. PEP severity was assessed using the Atlanta Criteria, Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), and Ranson’s criteria.

Multivariate regression analysis found that the likelihood of PEP was significantly higher among women participants, in whom the odds was over eight times as high as in men (odds ratio [OR], 8.1, 95 percent confidence interval [CI], 1.7–37.7; p=0.001).

JPD and SOD also emerged as potential risk factors, though with much weaker magnitudes of effect that were only of borderline significance.

Patients were then divided according to decades of life, which showed that those who were 20–30 years of age had the highest PEP prevalence (7.7 percent). In comparison, those in their sixth, seventh, eighth, and ninth decades of life had PEP prevalence rates of 4.2 percent, 4.7 percent, 4.1 percent, and 0 percent, respectively. APACHE II and Ranson’s criteria showed that PEP severity tended to peak during the seventh decade of life.

“According to our findings, age does not increase PEP. The most important PEP risk factor among the elderly is female gender, while the risk increases slightly with SOD and JPD. The results of that study suggest that advanced age should not hinder endoscopist for performing ERCP procedure if indication is present,” the researchers said.