Predicting the Risk of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis

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dc.contributor.advisorForbes, Nauzer
dc.contributor.authorMeng, Zhao Wu
dc.contributor.committeememberBrenner, Darren
dc.contributor.committeememberHeitman, Steve
dc.date2023-11
dc.date.accessioned2023-07-17T16:30:09Z
dc.date.available2023-07-17T16:30:09Z
dc.date.issued2023-07
dc.description.abstractBackground Post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) can lead to significant morbidity and even mortality. The aim of this study was to develop a PEP prediction model using easily accessible patient- and procedure-related variables. Methods Using a multi center prospective ERCP registry, we conducted logistic regression using stepwise selection on several patient- and procedure-related variables that were determined a priori. Variables were included or excluded based on an initial alpha cut-off of 0.2. The final model was based on a combination of Bayesian information criterion (BIC) and Akaike's information criterion (AIC) performance, as well as on the inclusion of variables deemed to be of clinical relevance, while maintaining face validity. All available data was used for model development, with subsequent internal validation performed on bootstrapped data using 10-fold cross validation. Results From September 1, 2019 to January 16, 2022, 3021 ERCP procedures were enrolled and included in our study. There were 151 (5.0%) cases of PEP. Variables included in the final model were patient sex, patient age, pancreatic duct cannulation, native papilla status, presence of precut sphincterotomy, cannulation time, presence of biliary stricture, and pancreatic duct stenting. The final model had an AIC, BIC, and receiver operating characteristic (ROC) curve of 822.28, 886.77, and 0.79, respectively. Bootstrapped data using 800 replicates revealed a C-statistic of 0.78 and expected to observed (E:O) ratio of 1.003. Conclusion This study successfully established and internally validated a promising PEP predictive model using easily obtainable variables that are known at baseline or observed during the ERCP procedure. The model achieved an area under the curve of 0.79. External validation is required prior to clinical use.
dc.identifier.citationMeng, Z. W. (2023). Predicting the risk of post endoscopic retrograde cholangiopancreatography pancreatitis (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.urihttps://hdl.handle.net/1880/116737
dc.identifier.urihttps://dx.doi.org/10.11575/PRISM/41579
dc.language.isoen
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgary
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectendoscopic retrograde cholangiopancreatography
dc.subjectpost-ERCP pancreatitis
dc.subject.classificationEducation--Health
dc.titlePredicting the Risk of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis
dc.typemaster thesis
thesis.degree.disciplineMedicine – Community Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.thesis.accesssetbystudentI do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.
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