Association of periampullary diverticulum types with post-ERCP hyperamylasemia: a retrospective observational study
BMC Gastroenterology, cilt.25, sa.1, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.1186/s12876-025-03896-x
- Dergi Adı: BMC Gastroenterology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
- Anahtar Kelimeler: Endoscopic retrograde cholangiopancreatography, Hyperamylasemia, Periampullary diverticulum types
- Akdeniz Üniversitesi Adresli: Hayır
Özet
Background: This study aimed to assess the prevalence of periampullary diverticulum (PAD) among endoscopic retrograde cholangiopancreatography (ERCP) patients in Southwestern Turkey and investigate the association between the new PAD classification, post-ERCP hyperamylasemia, and post-ERCP pancreatitis (PEP). Materials and methods: We retrospectively reviewed 1,317 ERCP procedures performed between January 1, 2022, and December 31, 2023, at Antalya Training and Research Hospital. The PAD type was determined according to the He-xian Shi classification. Hyperamylasemia was defined as an increase of three times the normal level of amylase at 4 to 6 h, and PEP was defined as hyperamylasemia along with abdominal pain lasting more than 24 h. Results: A total of 594 naive patients who underwent ERCP were analyzed. PAD was present in 137 patients (23.1%), and the success rate of choledochal cannulation in the first ERCP procedure was 94.3%. There was no difference in the choledochal cannulation rate between patients with and without PAD (95.6%-93.4%, p = 0.59). Asymptomatic hyperamylasemia was observed in 19.3% of the patients. Post-ERCP hyperamylasemia rates were similar between patients with and without PAD (17.5% and 21.2% respectively, p = 0.31). PEP was observed in 8.0% of the patients. Presence of PAD was not a risk factor for post-ERCP pancreatitis (7.3% compared to 8.8%, p = 0.82). When we checked the results according to the type of PAD, the prevalence of post-ERCP hyperamylasemia was significantly lower in patients with type 2b PAD than in those with type 1 and type 2a patients. Conclusion: PAD is a common finding in ERCP patients, with a prevalence of 23.1% in our cohort. The rate of choledochal cannulation, post ERCP hyperamylasemia and PEP did not differ between the patients with and without PAD. However, the type of PAD is important; post-ERCP hyperamylasemia is significantly lower in patients with type 2b than in type 1 and type 2a PAD patients. Different subtypes of PAD may have different associations on ERCP outcomes. Further investigations with refined and standardized PAD classification systems are needed.