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PTU-017 An audit of post ercp pancreatitis (pep) over four years in a uk tertiary centre
  1. HL Adams,
  2. SS Jaunoo
  1. Warwickshire Surgical Research Group, Warwickshire, UK

Abstract

Introduction The incidence of complications post ERCP is roughly 10%, with a reported mortality of around 1%. Pancreatitis (PEP) is the most common serious complication and although most are self-limiting, 10% develop severe pancreatitis resulting in considerable morbidity and occasional mortality. Determining incidence is difficult due to patient variation in selection for ERCP. This audit cycle over a four year period compares the incidence at a UK tertiary centre with the standard derived from guidance issued by the European Society of Gastrointestinal Endoscopy (ESGE).

Method Data was collected retrospectively using clinical coding to identify patients with post ERCP pancreatitis between 01/04/2010 and 31/03/2014. Electronic hospital records were analysed using set criteria to select those undergoing ERCP and developing subsequent pancreatitis.

Results 572 ERCPs were performed over this four year period. Nineteen patients undergoing ERCP in this time interval developed pancreatitis, with an incidence of 3.32%. Thirteen patients were female, and the median age at ERCP was 64 years. Most patients underwent ERCP due to gallstones however two patients had cholangiocarcinoma. Of the nineteen patients with PEP, five patients had been previously investigated with MRCP, and fourteen had received an upper abdominal ultrasound scan (USS). Three of the nineteen patients with PEP had an amylase level less than three times the upper limit of normal, however when compared with their baseline serum amylase, their post ERCP result was three times greater than their baseline level.

Conclusion Incidence of PEP at the UK tertiary centre was within the standard set by ESGE guidelines. There are no recommendations for improvement however re-audit should occur after April 2014 and should be carried out prospectively with additional outcome measures such as 30-day mortality, haemorrhage, perforation, cholangitis and cardiorespiratory complications.

Disclosure of interest None Declared.

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