Use of Pancreatic Endotherapy in Patients With Chronic Pancreatitis: Results From a Multicenter Cohort Study in the United States

Authors

Samuel Han
Darwin L Conwell
Jeffrey J Easler
Yunlong Yang
Dana K Andersen
William E Fisher
Evan L Fogel
Chris Forsmark
Phil A Hart
Steven J Hughes
Liang Li
Stephen J Pandol
Walter G Park
Jose Serrano
Stephen K Van Den Eeden
Santhi Swaroop Vege
Dhiraj Yadav
Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

Publication Date

8-1-2024

Journal

Gastrointestinal Endoscopy

DOI

10.1016/j.gie.2024.04.002

PMID

38583544

PMCID

PMC11528426

PubMedCentral® Posted Date

11-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Pancreatitis, Chronic, Female, Male, Middle Aged, United States, Cross-Sectional Studies, Adult, Cholangiopancreatography, Endoscopic Retrograde, Sex Factors, Cohort Studies, Aged, Logistic Models, Educational Status, Income, Risk Factors, Retreatment, Multivariate Analysis

Abstract

BACKGROUND AND AIMS: Although pancreatic endotherapy (PET) is commonly used for treating adverse events of chronic pancreatitis, data on the frequency and factors associated with the use of PET are limited. Our aim was to define the use of and factors predictive for receiving PET in a well-characterized chronic pancreatitis cohort.

METHODS: This is a cross-sectional analysis of data from PROCEED, a multicenter U.S. cohort study of chronic pancreatitis. PET modalities primarily consisted of ERCP. A treatment course was defined as the number of sessions performed for a specific indication. A repeat course was defined as PET >1 year after completion of the last course. Multivariable logistic regression identified predictive factors for receiving PET, and proportional rates model assessed risk factors for repeat PET.

RESULTS: Of 681 subjects, 238 (34.9%) received PET. Factors associated with receiving PET included female sex (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.03-1.53), lower education (OR, 1.30; 95% CI, 1.04-1.62), income ≤$50,000 per year (OR, 1.35; 95% CI, 1.07-1.71), and prior acute pancreatitis (OR, 1.74; 95% CI, 1.31-2.32). Of 238 subjects, 103 (43.3%) underwent repeat PET at a median duration of 2 years, with 23.1% receiving 2 courses, 9.7% receiving 3 courses, and 10.4% receiving ≥4 courses.

CONCLUSIONS: Nearly half of patients with chronic pancreatitis who undergo PET received 1 or more repeat courses within 2 to 3 years. In addition to a prior history of acute pancreatitis, demographic and socioeconomic factors were associated with receiving PET.