D0429 - Post-ERCP Pancreatitis: Does Diet Matter?

Mark Patrick Cubillan, MD¹, Kara L. Raphael, MD^2
1Zucker School of Medicine at Hofstra/Northwell Northshore and Long Island Jewish Hospital, Manhasset, NY; ²Zucker School of Medicine at Hofstra/Northwell, Northwell Health, North Shore University Hospital, Great Neck, NY

Introduction: Post-ERCP pancreatitis (PEP) is one of the most feared and most common complications of an ERCP, with an incidence of approximately 9.7%. While several risk factors for PEP have been established, the relationship between post-procedure diet and PEP is not well understood. We sought to evaluate whether a regular diet immediately post-ERCP was associated with an increase in PEP.

Methods: This was a retrospective study during which consecutive patients at two academic medical centers who underwent ERCP in 2021 were evaluated. Inclusion criteria were a) patients ≥ 18 years old; b) inpatient status prior to ERCP; c) no prior history of ERCP; d) no prior history of pancreatitis; e) no prior history of Sphincter of Oddi dysfunction. Data collected from these patients included patient demographics, ERCP procedure details, pre- and post- ERCP diet orders, and post- procedure complications. Association with PEP was evaluated using X² and Fisher’s exact tests.

Results: 100 consecutive patients met inclusion criteria and were included in this study. Overall, 74 patients (74%) received a modified post-ERCP diet, and 26 (26%) of patients received a regular post-ERCP diet. There was no significant difference in the incidence of PEP between these two groups (7/74 (9.4%) vs 0/26 (0%), p = 0.185). Cannulation type was found to be significantly associated with the development of PEP (standard cannulation, 2/72 (2.7%) vs other cannulation (double wire, needle knife, sphincteroplasty- assisted), 5/25 (20%), p=0.011). No other factors were found to have a significant association with the development of PEP (Table 1).

Discussion: In this cohort of 100 patients, post-ERCP diet choice was not found to be associated with the development of PEP. In fact, the only factor that was associated with PEP was a non-standard cannulation during ERCP, which is a well-established risk factor. The lack of association of post ERCP diet with PEP is an important finding because it is a common practice for endoscopists to recommend a modified consistency diet post ERCP to reduce the risk of PEP despite the lack of supporting evidence for this recommendation. Immediate advancement to a regular diet has significant benefits including aiding in patient recovery, reducing hospital length of stay, and improving patient satisfaction. Larger scale studies to corroborate this data in a prospective fashion are indicated.



Disclosures:


Mark Patrick Cubillan, MD¹, Kara L. Raphael, MD². D0429 - Post-ERCP Pancreatitis: Does Diet Matter?, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.