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Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?

Publication ,  Journal Article
DiMagno, MJ; Wamsteker, E-J; Maratt, J; Rivera, MA; Spaete, JP; Ballard, DD; Elmunzer, J; Saini, SD
Published in: Pancreas
May 2014

OBJECTIVE: Fluid therapy is a cornerstone of the early treatment of acute pancreatitis (AP), but data are conflicting on whether it affects disease severity. Administering greater fluid volumes (FVs) during induction of experimental AP preserves pancreatic perfusion and reduces severity but does not prevent onset of AP. We hypothesized that administering larger FV during endoscopic retrograde cholangiopancreatography (ERCP) associates with less severe post-ERCP pancreatitis (PEP). METHODS: In a retrospective cohort study, we identified 6505 patients who underwent 8264 ERCPs between January 1997 and March 2009; 211 of these patients developed PEP (48 mild, 141 moderate, and 22 severe). Data for FVs were available for 173 patients with PEP. RESULTS: In univariable analysis, only 1 of 16 variables was significantly associated with moderate to severe PEP--larger periprocedural FV was protective (0.94 T 0.3 L vs 0.81 T 0.4 L; P = 0.0129). Similarly,multivariable analysis of moderate to severe PEP identified 1 independent predictor-- larger periprocedural FV was protective (odds ratio, 0.20; 95% confidence interval, 0.05-0.83). Conversely, moderate to severe disease correlated with larger FV administered after PEP diagnosis(reflecting treatment decisions). CONCLUSIONS: This hypothesis-generating study suggests that administering larger periprocedural FVs is protective against moderate to severe PEP. Prospective studies on this topic are warranted.

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Published In

Pancreas

DOI

EISSN

1536-4828

Publication Date

May 2014

Volume

43

Issue

4

Start / End Page

642 / 647

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Pancreatitis
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

APA
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ICMJE
MLA
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DiMagno, M. J., Wamsteker, E.-J., Maratt, J., Rivera, M. A., Spaete, J. P., Ballard, D. D., … Saini, S. D. (2014). Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis? Pancreas, 43(4), 642–647. https://doi.org/10.1097/MPA.0000000000000101
DiMagno, Matthew J., Erik-Jan Wamsteker, Jennifer Maratt, Mari A. Rivera, Joshua P. Spaete, Darren D. Ballard, Joseph Elmunzer, and Sameer D. Saini. “Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?Pancreas 43, no. 4 (May 2014): 642–47. https://doi.org/10.1097/MPA.0000000000000101.
DiMagno MJ, Wamsteker E-J, Maratt J, Rivera MA, Spaete JP, Ballard DD, et al. Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis? Pancreas. 2014 May;43(4):642–7.
DiMagno, Matthew J., et al. “Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis?Pancreas, vol. 43, no. 4, May 2014, pp. 642–47. Pubmed, doi:10.1097/MPA.0000000000000101.
DiMagno MJ, Wamsteker E-J, Maratt J, Rivera MA, Spaete JP, Ballard DD, Elmunzer J, Saini SD. Do larger periprocedural fluid volumes reduce the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis? Pancreas. 2014 May;43(4):642–647.

Published In

Pancreas

DOI

EISSN

1536-4828

Publication Date

May 2014

Volume

43

Issue

4

Start / End Page

642 / 647

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Pancreatitis
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
  • Humans