Background: Most of the studies on the abdominal pain associated with endoscopic retrograde cholangiopancreatography (ERCP) are aimed at solving the pain during the procedure. Post-ERCP abdominal pain has rarely been investigated,and few studies have focused on the characteristics and risk factors of post-ERCP abdominal pain without post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP).This study aimed to identify risk factors of post-ERCP abdominal pain without PEP and investigate characteristics of the abdominal pain in non-PEP patients.
Methods: From August 6th, 2019, to January 15th, 2020, data of patients who underwent ERCP were retrospectively collected. The characteristics of the abdominal pain after ERCP were recorded and compared between PEP and non-PEP patients. Multivariate analysis was conducted to identify risk factors of non-PEP abdominal pain.
Results: Data from 616 ERCP procedures were retrospectively investigated in this study, among which 51(8.28%) patients presented post-ERCP abdominal pain without PEP and 45 (7.31%) patients developed PEP. Multivariate analysis found that 5 risk factors were associated with non-PEP abdominal pain: female gender (OR:2.137), upper abdominal surgery history (OR:1.948), first time ERCP (OR:4.735), elevated serum γ-glutamyl transferase (𝛾-GT) (OR:2.570) and elevated serum direct bilirubin (DBIL) (OR:2.932). Visual analogue sale (VAS) score of PEP abdominal pain was higher than that of non-PEP pain group (P=0.05). There were no significant differences in the time of the onset of the pain, pain relief time, pain frequency, use of analgesic medicine, hospital stay and mortality between PEP and non-PEP pain group(P<0.05).
Conclusion: This study indicated that female gender, upper abdominal surgery history, first time ERCP, elevated 𝛾-GT and elevated DBIL were independent risk factors for post-ERCP abdominal pain without PEP. Abdominal pain was severer in PEP patients than non-PEP patients.