Practice patterns and use of endoscopic retrograde cholangiopancreatography in the management of recurrent acute pancreatitis

• Type of Material: Article
• Authors: Jonathan B. Reichstein, Duke University; Vaishali Patel, Emory University; Parit Mekaroonkamol, Emory University; Sunil Dacha, Emory University; Steven Keilin, Emory University; Qiang Cai, Emory University; Field Willingham, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: Clinical Endoscopy
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Korean Society of Gastrointestinal Endoscopy.
• License: Creative Commons Attribution-Noncommercial 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.5946/ce.2019.052
• Title of Journal or Parent Work: Clinical Endoscopy
• Volume: 53
• Issue: 1
• Start Page: 73
• End Page: 81
• Keywords: Endoscopic retrograde cholangiopancreatography; Practice patterns; Recurrent acute pancreatitis; Pancreas divisum
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US. Methods: An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios. Results: The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP. Conclusions: A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP.