Factores de riesgo asociados a pancreatitis e hiperamilasemia postcolangiopancreatografia retrograda endoscópica (CPRE) en pacientes del Hospital Teodoro Maldonado Carbo (IESS) desde enero a diciembre del 2017.

Abstract

Introduction: Pancreatitis is a very serious entity that can occur in anyone while hyperamylasemia has minimal significance in studies; both are pathologies that appear after the endoscopic retrograde cholangiopancreatography (ERCP), to this are added a series of factors which will be detailed in this thesis, carried out in the area of Gastroenterology of the HTMC (IESS). Studies describe that in Ecuador, choledocholithiasis and bile duct obstruction are very common risk factors, therefore, it is important to know the different risk factors and identify the patients most likely to have pancreatitis and / or post-ERCP hyperamylasemia and be able to provide appropriate recommendations that have applicability in future clinical practice. Object: Identify the risk factors associated with the occurrence of pancreatitis and / or hyperamylasemia whether symptomatic or asymptomatic in patients undergoing ERCP at the Teodoro Maldonado Carbo Hospital (IESS) from January to December 2017. Methodology: Prevalence or Transversal Court Study (Observational, descriptive). Study of patients treated from January 2017 to December 2017 at the Teodoro Maldonado Carbo Hospital (IESS) who underwent ERCP, with their surgical parts and medical records and complementary examinations with their reference values from the Hospital's laboratory. Results: This study was clearly associated with 15% of pancreatitis after ERCP, based on choledocholithiasis and bile duct stenosis as a high predisposing factor, and a higher incidence was identified in women (66.4%) than in men (33.6%) of the 125 patients (55.56%) who were studied. This clears the hypothesis raised, recognizing that about 80% of cases are reported as pancreatitis and hyperamylasemia after ERCP, and a contrast is made when reviewing in the medical records of Teodoro Maldonado Carbo Hospital with reviewed studies. It is revealed the incidence of patients with hyperamylasemia who were 19 (15.2%) giving the result 8.4% as well as the incidence of pancreatitis after ERCP, that is, the two entities go hand in hand. When reviewing the clinical manifestations between hyperamylasemia versus post-ERCP pancreatitis, both are related to the heavy pain that is what gives the final verdict. Finally, the result of small papillotomies against large ones is not associated with hyperamylasemia or pancreatitis after ERCP, resulting in extensive papillotomies 70 patients (56%) and small papillotomies 55 patients (44%), thus the contrast of 15.2% of the patients who had post-ERCP pancreatitis. Conclusion: In this way I can conclude that the greatest risk factor of the female sex goes hand in hand with the table of why the CRE is performed, where there were options such as cholelithiasis, choledocholithiasis and stenosis; here, bile duct stenosis and choledocholithiasis win, where both achieve 36 and 41% as a risk factor for ending in ERCP. Thus my hypothesis is clarified, the highest percentage of risk factor is being a woman and managing a choledocholithiasis or bile duct stenosis.