Unraveling Risk Factors and Disparities in Post-ERCP Acute Pancreatitis: A Clinical Exploration into Oddi Sphincter Morphology at the Duodenal Papilla
Authors: Yang Yanfei , Du Ziqiang , Liu Guoshuai , Zhang Qi , Luo Xu , Tan Guang 
Published: May 2024

Background
To investigate the risk factors for pancreatitis and their variability after endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary tract diseases.
Methods
The clinical data of a total of 234 patients who underwent ERCP for biliary tract diseases at the First Affiliated Hospital of Dalian Medical University from June 2023 to November 2023 were retrospectively analyzed, and a total of 149 patients were enrolled after inclusion and exclusion criteria were applied.This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University, and the relevant guidelines and regulations have been strictly followed. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University, and the relevant guidelines and regulations have been strictly followed.According to the morphology of Oddi type sphincter of duodenal papilla, patients were classified as normal papillary muscle morphology and normal sphincter. According to the Oddi sphincter morphology of the duodenal papilla, the patients were divided into two layers: normal papillary muscle morphology and abnormal papillary muscle morphology, retrieved their baseline data, and then divided into the PEP group and non-PEP group according to the occurrence of PEP, based on the different stratification and grouping of the clinical baseline data, and the statistically significant results of the difference in the analysis of the difference in the relevant visualization. Patients were divided into study group (n=34, with PEP) and control group (n=115, without PEP) according to whether they had post-ERCP pancreatitis (PEP) or not, and their clinical baseline data were retrieved and compared. Their statistically significant risk factors for PEP were analyzed based on Lasso regression and logistic regression.
Results
In the DPS=0 group, the factors significantly associated with PEP are SA,PH,PS,IT,OSD,PAP,PI,NRG,PAG,PLG.In the DPS=1 group, the risk factors are BMI,SA,PH,IT,OSD,PAP,APG,PAG and PLG. The risk factors that are common between the groups for the occurrence of PEP are SA,PH,IT,OSD,PAP,PAG,PLG. OSD, PAP, PAG, PLG. In the between-group comparison analysis of variance, the most significant differences between groups are IT (t: 2.449, P: 0.0220) and OSD (t: -3.647, P: 0.0012). In the Lasso regression analysis and logistic regression analysis, it has been found that: gender, C, PS, IT, PI, OSD, PAP, PAR, NRG (2), TBG (2), PG, PAG, PLG (1), and ET are independent risk factors for the promotion of PEP as its occurrence.
Conclusion
According to DPS=0 and DPS=1 stratified intergroup correlation comparison variability analysis we have found that the common risk factors associated with PEP are SA,PH,IT,OSD,PAP,PAG,PLG, and the risk factors with the most significant intergroup variability are IT and OSD.Gender, C, PS, IT, PI, OSD, PAP, PAR, NRG (2), TBG(2), PG, PAG, PLG(1), and ET are independent risk factors for PEP. This study can assist clinicians to make a comprehensive and reasonable assessment of patients who are about to undergo ERCP, and to make relevant clinical interventions in a timely manner, so as to improve the prognosis of the patients.