Risk factors for pancreatitis after pancreatic sphincterotomy: a review of 572 cases
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND AND STUDY AIMS: Endoscopic pancreatic sphincterotomy is indispensable for many therapeutic endoscopic maneuvers, but is also associated with a higher risk of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). In this study, this subgroup of patients was investigated in order to identify risk factors and protective factors. PATIENTS AND METHODS: A retrospective chart review identified 572 endoscopic pancreatic sphincterotomies that met the inclusion criteria. Charts were examined for indications, endoscopic technique, and outcomes, including pancreatitis. RESULTS: A total of 477 patients underwent 572 endoscopic pancreatic sphincterotomies during a 5-year period. Indications for sphincterotomy included chronic pancreatitis (n = 398), access for tissue sampling (n = 52), acute recurrent pancreatitis (n = 45), transpapillary drainage of a pancreatic pseudocyst (n = 32), precut access to the common bile duct (n = 29), and others (n = 16). Pancreatic duct drainage was performed in 69.1 % of the procedures (nasopancreatic catheter, n = 290, or pancreatic stent placement, n = 105). Post-ERCP pancreatitis occurred in 69 cases (12.1 %) and was severe in 10. The multivariate analysis identified female sex as being associated with a higher risk of pancreatitis, while an elevated C-reactive protein level, pancreatic ductal stones, sphincterotomy at only the major papilla, and pancreatic duct drainage with a nasopancreatic catheter or stent were associated with a lower risk. CONCLUSIONS: This large series of patients undergoing endoscopic pancreatic sphincterotomy provides further evidence that both patient characteristics and technical factors modify the risk profile for post-ERCP pancreatitis. In addition to providing further definition of which patients are at risk, it also suggests that pancreatic duct drainage is an independently significant protective maneuver.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it