# Prevalence and Characteristics of Post-endoscopic Retrograde Cholangiopancreatography (ERCP) Complications in Patients With Biliopancreatic Disorders: A Retrospective Study

## TL;DR

This study examines how often and under what conditions complications like pancreatitis occur after ERCP procedures in Mexico, comparing patients with and without biliary stents.

## Contribution

The study provides new insights into ERCP complication rates and patient characteristics in a Mexican secondary-level hospital setting.

## Key findings

- Post-ERCP pancreatitis occurred in 4% of non-stent patients and 3.9% of stent patients.
- Choledocholithiasis was more common in non-stent patients, while biliary strictures and unresolved stones were more frequent in stent patients.
- Female patients had a higher incidence of complications, and hyperlipasemia and hyperamylasemia were common without clinical pancreatitis.

## Abstract

Objective: To determine the prevalence and clinical characteristics of post-endoscopic retrograde cholangiopancreatography (ERCP) complications, particularly acute pancreatitis, in patients with biliopancreatic disorders treated at a secondary-level referral hospital in Mexico between April 1, 2020, and December 31, 2023, and to compare outcomes between patients who received biliary stents and those who did not.

Materials and methods: This was an observational and retrospective study conducted at a secondary-level hospital in Mexico. A total of 151 medical records of patients who underwent ERCP were reviewed. Variables included sex, age, hyperamylasemia, hyperlipasemia, acute post-ERCP pancreatitis, and related complications.

Results: The study included 151 patients, with a median age of 51 years and a predominance of female patients (60%, n = 90). Biliary stents were placed in 66% (n = 100), while 34% (n = 51) did not receive a stent. The most common indications for ERCP were choledocholithiasis (76%, n = 115), biliary stricture (11%, n = 16), suspected biliary tumor (4%, n = 6), and other causes (9%, n = 14). Post-ERCP pancreatitis, defined as abdominal pain following the procedure accompanied by elevated lipase and amylase levels, occurred in 4% (n = 4) of patients without a stent and 3.9% (n = 2) with a stent. Isolated hyperlipasemia and hyperamylasemia without clinical pancreatitis occurred in 11% (n = 17) and 8.6% (n = 13) of patients, respectively. Significant differences were observed in ERCP indications between groups: choledocholithiasis was more frequent in the non-stent group (90%, n = 90 of 100) compared to the stent group (49%, n = 25 of 51), whereas biliary strictures (25%, n = 13 of 51 vs. 3%, n = 3 of 100) and unresolved stones (80%, n = 41 of 51 vs. 25%, n = 25 of 100) were more common in the stented group (all p < 0.001).

Conclusion: The prevalence of post-ERCP pancreatitis was consistent with that reported in the international literature, with a higher incidence in women. ERCP continues to play a key role in the management of biliopancreatic diseases, underscoring the importance of ongoing research to enhance comprehensive care for the Mexican population.