Impact of body mass index on the incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis

Abstract

Background: Pancreatitis is a potential major complication after endoscopic retrogradecholangiopancreatography (post-ERCP pancreatitis; PEP). Obesity has been associated withincreased severity of acute pancreatitis. However, the correlation between obesity and PEP iscontroversial. Therefore, our study aimed to clarify the relationship between body mass index(BMI) and the incidence and severity of PEP.Methods: A retrospective cohort study was conducted to elucidate the relationship between BMIand PEP in all patients who underwent ERCP in a tertiary referral center between January 2009and October 2016. Patient characteristics and procedure details were collected. PEP was definedby consensus criteria. Multivariate logistic regression was used to determine the associationbetween BMI and PEP.Results: The analysis included 2236 patients whose BMI was recorded and had adequate follow up(921 with BMI≥30 kg/m2, 1315 with BMI<30 kg/m2). PEP was diagnosed in 107 (4.8%) patients.PEP was seen in 49 obese patients (5.3%) and 58 non-obese patients (4.4%). In the univariate andmultivariate analysis BMI≥30 kg/m2 was not associated with PEP (odds ratio 1.2, 95%CI 0.8-1.8;P=0.32). A subgroup analysis of different BMI subcategories found that BMI was not associatedwith the incidence or severity of PEP.Conclusion: In the largest study to date, neither obesity nor low body weight increased theincidence or severity of PEP