Pancreas
Gastrointest Endosc. 2024;99(2):214–23.e4
Clinical impact of pancreatic steatosis measured by CT on the risk of post-ERCP pancreatitis: A multicenter prospective trial
Background and aims: Pancreatic steatosis (PS) may be a risk factor for acute pancreatitis. Whether it is also a risk factor for post-ERCP pancreatitis (PEP) has not been evaluated. This study aimed to determine the impact of PS on PEP development.
Methods: This multicenter prospective trial enrolled 786 consecutive patients who underwent contrast-enhanced abdominal computed tomography (CT) and subsequent first-time endoscopic retrograde cholangiopancreatography (ERCP). PS was evaluated based on pancreatic attenuation on unenhanced CT images. The risk of PS for the development of PEP was evaluated using a logistic regression model.
Results: Of 527 patients included in the study, 157 (29.8%) had PS and 370 (70.2%) did not. At 24 hours after ERCP, there was a significant difference in the PEP identified in 22 patients (14.0%) in the PS group and 23 patients (6.2%) in the “no PS” (NPS) group (p = 0.017). Diabetes and hypertension were more common in the PS group than in the NPS group; no differences in dyslipidemia were found. Patients with PS had a higher risk for the development of PEP than those with NPS (odds ratio = 2.09; 95% confidence interval: 1.08–4.03). No other variables were identified as risk factors for PEP.
Conclusions: Pancreatic steatosis (PS) is a significant risk factor for post-ERCP pancreatitis for which preventive measures should be considered. Standardized measurement protocols to assess PS by computed tomography are needed.