Does obesity increase the incidence and severity of post-ERCP pancreatitis?

S. Sherman, G. Lehman, D. Earle, J. Watkins, J. Barnett, J. Johanson, M. Freeman, J. Geenen, M. Ryan, H. Parker, E. Lazaridis, J. Flueckiger, A. Slivka, K. Dua, G. Aliperti, P. Yakshe, M. Uzer, W. Jones, J. Goff

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Abstract

Emphasis has been placed on the importance of obesity as a predictor of poor outcome from acute pancreatitis. The aim of this study was to determine whether obesity confers an increased risk and severity of post-ERCP pancreatitis. METHODS: A 160 variable database was prospectively collected by a defined protocol on patients undergoing diagnostic or therapeutic ERCP and participating in a randomized controlled trial evaluating whether prophylactic corticosteroids will reduce the incidence of post-procedure pancreatitis. Data were collected at the time of the procedure, prior to and after discharge. Standardized criteria were used to diagnose and grade the severity of post-procedure pancreatitis (GI Endosc 1991;37:383). Mild pancreatitis required 2-3 days of hospitalization; moderate pancreatitis required 4-10 days; severe pancreatitis required >10 days or surgical/invasive radiologic intervention or was associated with a complication. A body mass index (BMI) >30kg/m2 is generally regarded as obese (National Academy of Sciences) and was used as the cutoff point in this study. RESULTS: 935 patients were entered into the study. Pancreatitis occurred in 139 patients (14.9%) and was graded mild in 93 (9.9%), moderate in 38 (4.1%), and severe in 8 (.9%). Data on BMI were available on 791 patients (84.6%). There was no statistically significant association between the presence of obesity and the development of post-ERCP pancreatitis (p=0.143). There was no association between obesity and the severity of the pancreatitis (p=.381). The following table displays the mean BMI for each level of pancreatitis severity. Grade of Pancreatitis N Mean BMI None 671 26.75 Mild 82 25.78 Moderate 35 25.03 Severe 3 33.09 There was only a marginal relationship between BMI and severity of pancreatitis (p= 098). CONCLUSIONS: 1) Obesity did not seem to confer an increased risk for post-ERCP pancreatitis. 2) There was no statistically significant association between obesity and the severity of post-procedure pancreatitis. 3) There may be a weak relationship between BMI and the severity of pancreatitis. 4) This study is ongoing.

Original languageEnglish (US)
Pages (from-to)AB164
JournalGastrointestinal endoscopy
Volume45
Issue number4
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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    Sherman, S., Lehman, G., Earle, D., Watkins, J., Barnett, J., Johanson, J., Freeman, M., Geenen, J., Ryan, M., Parker, H., Lazaridis, E., Flueckiger, J., Slivka, A., Dua, K., Aliperti, G., Yakshe, P., Uzer, M., Jones, W., & Goff, J. (1997). Does obesity increase the incidence and severity of post-ERCP pancreatitis? Gastrointestinal endoscopy, 45(4), AB164. https://doi.org/10.1016/S0016-5107(97)80560-3