While the need for endoscopic retrograde cholangiopancreatography (ERCP), which can diagnose and treat various diseases of the bile duct and pancreatic duct, has recently been rapidly increasing, research has shown that pancreatitis is more likely to occur after ERCP in patients with pancreatic steatosis.
A joint research team including Professors Se-Woo Park (corresponding author, photo), Kyeong-Ju Lee, Jin Jin, and Dong-Hee Ko of the Department of Gastroenterology at Hallym University Dongtan Sacred Heart Hospital, and Professor Seon-Jeong Min of the Department of Radiology, as well as Severance Hospital, Ilsan Cha Hospital, and Hanyang University Hospital, concluded that ‘pancreatic steatosis measured by CT scan was observed after ERCP. They said that this fact was confirmed in ‘Clinical Impact on the Development of Pancreatitis: A Multicenter Prospective Study’.
ERCP is a procedure in which an endoscope is inserted into the duodenum, a contrast agent is injected into the bile duct and pancreatic duct through a small hole called the duodenal papilla, and lesions are observed.
After ERCP, complications such as acute pancreatitis, bleeding, and perforation may occur. In particular, acute pancreatitis requires long-term treatment and causes a significant socioeconomic burden. The incidence of pancreatitis after ERCP is known to be approximately 4.5% in patients with average risk and approximately 10% in high-risk patients, and prevention methods are not well known to date.
As a result of the study, it was 2.09 times higher than the group without
Stimulates secretion of metabolites such as cytokines
The research team investigated the occurrence of pancreatitis after ERCP in 527 people who underwent ERCP at Hallym University Dongtan Sacred Heart Hospital and other hospitals from November 2020 to July 2022. Of the total patients, 157 had pancreatic steatosis, which is fat in the pancreas, and the presence of pancreatic steatosis was determined through a CT scan.
As a result of the analysis, pancreatitis occurred in 14% (22 people) of 157 people with pancreatic steatosis and 6.2% (23 people) of 370 people without pancreatic steatosis. Additionally, the probability of developing pancreatitis after ERCP was found to be 2.09 times higher in the group with pancreatic steatosis than in the group without pancreatic steatosis.
Professor Park Se-woo said, “If ERCP is performed on a patient with pancreatic steatosis, it can serve as a basis for implementing preventive measures such as prescription of non-steroidal anti-inflammatory drugs.” He added, “In this study, age, female sex, and diabetes were risk factors for the development of pancreatic steatosis.” ·Metabolic syndrome such as high blood pressure was chosen,” he explained.
He continued, “As we age, the pancreatic parenchyma decreases and turns into fat. In the process of storing and releasing fatty acids, fat cells stimulate the secretion of metabolites such as cytokines, chemokines, and adipokines that cause various inflammations.” He added that caution should be taken against the occurrence of pancreatitis due to pancreatic steatosis.
/Reporter Gu Min-ju [email protected]
2023-09-26 09:47:40
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