# Prevalence and Related Factors of Post-ERCP Pancreatitis in Cholangiocarcinoma Patients: A Retrospective Study in Northeast Thailand

## TL;DR

This study finds that about 26% of cholangiocarcinoma patients develop pancreatitis after ERCP, with older age and certain procedures increasing the risk.

## Contribution

The study identifies specific risk factors for post-ERCP pancreatitis in cholangiocarcinoma patients in a regional population.

## Key findings

- Post-ERCP pancreatitis occurred in 26.4% of cholangiocarcinoma patients.
- Older age, metallic stent placement, and post-ERCP cholangitis were independent risk factors for pancreatitis.
- Bilirubin levels ≥ 15 mg/dL were found to be protective against severe pancreatitis.

## Abstract

Background/Objectives: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is a frequent but insufficiently studied complication in cholangiocarcinoma (CCA). This study aimed to evaluate incidence and risk factors of PEP in CCA. Methods: We retrospectively reviewed 148 CCA patients who underwent ERCP between 2019 and 2022. Demographic, clinical, and procedural data were compared between patients with and without PEP, and logistic regression was used to identify independent predictors. Results: PEP occurred in 26.4% of patients, mostly aged ≥ 66 years, male, and with perihilar CCA. In PEP cases, metallic stents were frequently used, procedures often exceeded 60 min, and 28.2% developed post-ERCP cholangitis. Hospital stay was ≥4 days in nearly 90% of cases. PEP severity was mild (10.3%), moderate (61.5%), and severe (28.2%). Multivariate analysis showed older age, metallic stent placement, and post-ERCP cholangitis as independent risk factors, while bilirubin ≥ 15 mg/dL was protective. Conclusions: PEP occurred in over one-fourth of CCA patients, predominantly of moderate severity. Independent risk factors included older age, metallic stent placement, and post-ERCP cholangitis, whereas bilirubin ≥ 15 mg/dL was protective. Awareness of these factors may aid risk stratification and prevention in this high-risk group.