Analysis of Risk Factors Associated with the Severity of Biliary Pancreatitis

Oh, Hyo Jeong; Kim, Tae Hyeon; Choi, Chang Soo; Kweon, Ji Hye; Lim, Pyoung Suk; Shin, Sae Ron; Choi, Suck Chei; Nah, Yong Ho

Abstract

BACKGROUND/AIMS: The aim of the study was to investigate the risk factors for biliary pancreatitis according to severity.
METHODS
This study retrospectively reviewed 58 patients who underwent endoscopic retrograde cholangiopancreatography for the management of acute biliary pancreatitis between November 2001 and June 2004. The severity of pancreatitis was classified as severe or mild pancreatitis according to the Glasgow scale. Multiple clinical and radiological factors were analyzed for a relationship with the severity of pancreatitis and coexisting biliary pathology.
RESULTS
Ten patients (17%) had severe pancreatitis (the SP group) and the remaining 48 patients (83%) had mild pancreatitis (the MP group). The diameter of the common bile duct CBD) and cystic duct, and the number and the size of gallstones were not significantly different between the two groups of patients. The number of patients without a periampullary diverticulum in the SP group (90.0%) was significantly higher than in the MP group (39.6%). Most of the SP patients (90.0%) had CBD stones (<5 mm) or CBD sludge, but the prevalence of CBD stones (<5 mm) or CBD sludge was lower in the MP group (54.2%, p=0.04). The absence of a periampullary diverticulum was identified as a risk factor according to severity by the use of logistic regression analysis (odds ratio=25; p=0.01).
CONCLUSIONS
The development of severe biliary pancreatitis was influenced by risk factors such as a CBD stone less than 5 mm or sludge and the absence of a periampullary diverticulum.