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Normal serum bilirubin level is the risk factor for post-ERCP pancreatitis in Sphincter of Oddi dysfunction types I

Ivan Mamontov1, Dmitro Ryabushchenko1, Tamara Tamm1

  • 1KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|February 1, 2026
PubMed

Insights

Normal serum bilirubin levels increase the risk of post-ERCP pancreatitis (PEP) in patients with sphincter of Oddi dysfunction (SOD) types I and II. Avoid ERCP with EST in these patients; consider medical treatment or advanced prophylaxis.

Area of Science:

  • Gastroenterology
  • Endoscopic Retrograde Cholangiopancreatography (ERCP)
  • Pancreatitis

Background:

  • Sphincter of Oddi dysfunction (SOD) types I and II can lead to complications.
  • Post-ERCP pancreatitis (PEP) is a significant risk following ERCP procedures.
  • Identifying risk factors for PEP is crucial for patient management.

Purpose of the Study:

  • To evaluate risk factors for PEP in patients undergoing ERCP for SOD types I and II.
  • To identify independent predictors of PEP in this patient cohort.

Main Methods:

  • Retrospective analysis of 107 patients with SOD types I and II undergoing ERCP.
  • Investigated potential risk factors including patient demographics, medical history, and procedural details.
  • Utilized univariate and multivariate analyses to identify independent risk factors for PEP.

Main Results:

  • The overall PEP rate was 14%.
  • Normal serum bilirubin level was identified as an independent risk factor for PEP (OR 9.574, p=0.007).
  • Precutaneous transhepatic biliary drainage (Precut) was associated with a reduced risk of PEP (OR 0.116, p=0.048).

Conclusions:

  • Normal serum bilirubin level is a significant independent risk factor for PEP in SOD types I and II.
  • ERCP with endoscopic sphincterotomy (EST) should be avoided in patients with normal bilirubin levels and SOD.
  • Alternative treatments or advanced prophylactic measures are recommended for these high-risk patients.
Abstract

Keywords:
ERCPEndoscopic retrograde cholangiopancreatographypost-ERCP pancreatitisrisk factorsphincter of Oddi dysfunction

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