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OBJECTIVES: To investigate the potential risk factors for endoscopic retrograde cholangiopancreatography (ERCP) complications and to identify whether the risk factors are different for pancreatitis and asymptomatic hyperamylasemia. METHODS: Consecutive ERCP procedures were studied at 14 centers in China from May 2006 to April 2007. The complications after the patients' first-only procedures were evaluated. Multivariate analysis based on the first-only procedures was used to identify the risk factors. RESULTS: A total of 3,178 procedures were performed on 2,691 patients. Overall, complications developed in 213 (7.92%) patients, pancreatitis in 116 (4.31%), and asymptomatic hyperamylasemia in 396 (14.72%). In the multivariate analysis, female gender (adjusted odds ratios (ORs): 1.52, 95% confidence interval (CI): 1.14 - 2.02, P = 0.004), periampullary diverticulum (OR: 2.02, 95% CI: 1.49 - 2.73, P < 0.001), cannulation time >10 min (OR: 1.51, 95% CI: 1.08 - 2.10, P = 0.016), ≥ 1 pancreatic deep wire pass (OR: 1.80, 95% CI: 1.33 - 2.42, P < 0.001), and needle-knife precut (OR: 2.70, 95% CI: 1.42 - 5.14, P = 0.002) were risk factors for overall complications. Female gender (OR: 1.84, 95% CI: 1.25 - 2.70, P = 0.002), age ≤ 60 year (OR: 1.59, 95% CI: 1.06 - 2.39, P = 0.025), cannulation time >10 min (OR: 1.76, 95% CI: 1.13 - 2.74, P = 0.012), ≥ 1 pancreatic deep wire pass (OR: 2.77, 95% CI: 1.79 - 4.30, P < 0.001), and needle-knife precut (OR: 4.34, 95% CI: 1.92 - 9.79, P < 0.001) were risk factors for pancreatitis. Cannulation time >10 min (OR: 1.96, 95% CI: 1.52 - 2.54, P < 0.001), ≥ 1 pancreatic deep wire pass (OR: 2.24, 95% CI: 1.74 - 2.89, P < 0.001), needle-knife precut (OR: 2.34, 95% CI: 1.32 - 4.14, P = 0.004), and major papilla pancreatic sphincterotomy (OR: 1.71, 95% CI: 1.23 - 2.37, P = 0.001) were risk factors for asymptomatic hyperamylasemia. CONCLUSIONS: Patient-related factors are as important as procedure-related factors in determining high-risk predictors for post-ERCP overall complications and pancreatitis. However, the risk factors for asymptomatic hyperamylasemia may be mostly procedure related. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Since the introduction of endoscopic retrograde cholangiopancreatology (ERCP) in clinical use, pancreatitis has become a common complication of ERCP. Octreotide is an inhibitor of pancreatic enzyme secretions. Several studies have evaluated the effect of octreotide on the incidence of clinical pancreatitis after ERCP, but with different results. The aim was to determine the efficacy of prophylactic administration of octreotide for the prevention of post-ERCP pancreatitis (PEP) and hyperamylasemia. METHODS: In this study, patients with scheduled ERCP were randomized to receive either octreotide (0.3 mg) via intramuscular injection or a placebo. The study was conducted in 12 digestive endoscopic units in China. Patients were randomized into two groups: an octreotide group (N = 414) and a control group (N = 418). In the octreotide group, octreotide (0.3 mg) was dissolved in 500 mL of 0.9% saline solution and administered by continuous intravenous infusion, beginning 1 h before endoscopic examination and continued for 6 h thereafter; 0.1 mg of octreotide was injected subcutaneously at 6 and 12 h after the intravenous injection was stopped. The control group was given a placebo intravenously. The end point was the development of acute pancreatitis. RESULTS: The overall incidence of acute pancreatitis was 3.85%; this included 2.42% (10/414) in the octreotide group and 5.26% (22/418) in the control group ( P= 0.046). The overall incidence of hyperamylasemia was 14.9%; 12.32% (51/414) in the octreotide group and 17.46% (73/418) in the control group ( P= 0.041). No side effects were found. CONCLUSION: The results indicate that octreotide can prevent PEP and hyperamylasemia. [ABSTRACT FROM AUTHOR]