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KMID : 0359020070350060385
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Korean Journal of Gastrointestinal Endoscopy
2007 Volume.35 No. 6 p.385 ~ p.390
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Analysis of Risk Factors Associated with the Severity of Biliary Pancreatitis
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Oh Hyo-Jeong
Kim Tae-Hyeon
Choi Chang-Soo
Kwon Ji-Hye
Lim Pyoung-Suk
Shin Sae-Ron
Choi Suck-Chei
Nah Yong-Ho
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Abstract
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Background/Aims: The aim of the study was to investigate the risk factors for biliary pancreatitis according to
severity.
Methods: This study retrospectively reviewed 58 patients who underwent endoscopic retrograde holangiopancreatography for the management of acute biliary pancreatitis between November 2001 and June 2004. The
severity of pancreatitis was classified as severe or mild pancreatitis according to the Glasgow scale. Multiple clinical and radiological factors were analyzed for a relationship with the severity of pancreatitis and coexisting biliary pathology.
Results: Ten patients (17%) had severe pancreatitis (the SP group) and the remaining 48 patients (83%) had mild pancreatitis (the MP group). The diameter of the common bile duct CBD) and cystic duct, and the number and the size of gallstones were not significantly different between the two groups of patients. The number of patients without a periampullary diverticulum in the SP group (90.0%) was significantly higher than in the MP group (39.6%). Most of the SP patients (90.0%) had CBD stones (＜5 mm) or CBD sludge, but the prevalence of CBD stones (＜5 mm) or CBD sludge was lower in the MP group (54.2%, p=0.04). The absence of a periampullary diverticulum was identified as a risk factor according to severity by the use of logistic regression analysis (odds ratio=25; p=0.01).
Conclusions: The development of severe biliary pancreatitis was influenced by risk factors such as a CBD stone less than 5 mm or sludge and the absence of a periampullary diverticulum.
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KEYWORD
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Biliary pancreatitis, Severity, Periampullary diverticulum
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