Cao XX, Sun M. Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators. World J Gastrointest Surg 2025; 17(12): 111003 [DOI: 10.4240/wjgs.v17.i12.111003]
Corresponding Author of This Article
Min Sun, Associate Professor, Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou 221000, Jiangsu Province, China. sunminnt820919@163.com
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Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 25, 2025
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Cao XX, Sun M. Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators. World J Gastrointest Surg 2025; 17(12): 111003 [DOI: 10.4240/wjgs.v17.i12.111003]
World J Gastrointest Surg. Dec 27, 2025; 17(12): 111003 Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.111003
Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators
Xun-Xun Cao, Min Sun
Xun-Xun Cao, Min Sun, Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Author contributions: Cao XX conceived the project, acquired and analyzed data, and wrote the manuscript; Sun M designed the study and edited and critically revised the manuscript; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Affiliated Hospital of Xuzhou Medical University, No. XYFY2023-KL375-01.
Informed consent statement: Due to the retrospective nature of the study, the Ethics Committee approved the waiver of informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original anonymous dataset is available upon request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Sun, Associate Professor, Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou 221000, Jiangsu Province, China. sunminnt820919@163.com
Received: June 24, 2025 Revised: July 28, 2025 Accepted: October 20, 2025 Published online: December 27, 2025 Processing time: 183 Days and 18.7 Hours
Abstract
BACKGROUND
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is a common complication of the procedure. The effective prevention of post-ERCP pancreatitis (PEP) remains a key focus of clinical research.
AIM
To develop a prediction model for PEP based on multidimensional clinical indicators and evaluate its clinical application value.
METHODS
We retrospectively analyzed 183 patients with biliary tract diseases who underwent ERCP at Xuzhou Medical University from January 2020 to June 2023, divided into non-PEP (n = 159) and PEP (n = 24) groups based on PEP development. Baseline and intraoperative data were compared, and PEP-related factors examined via univariate and multivariate logistic regression. Using R, 70% of patients were assigned to training and 30% to testing sets for PEP prediction model development. Model accuracy was evaluated using a calibration curve and receiver operating characteristic (ROC) area under the curve (AUC).
RESULTS
Age, total cholesterol level, history of pancreatitis, pancreatic ductography, bleeding, and intubation time differed significantly between the two groups when baseline data and intraoperative conditions were compared (P < 0.05). Multifactorial logistic regression analysis demonstrated that age [odds ratio (OR) = 0.192, 95% confidence interval (CI): 0.053-0.698], total cholesterol (OR = 0.324, 95%CI: 0.152-0.694), history of pancreatitis (OR = 6.159, 95%CI: 1.770-21.434), pancreatography (OR = 3.726, 95%CI: 1.028-13.507), and bleeding (OR = 3.059, 95%CI: 1.001-9.349) were independently associated with acute pancreatitis after ERCP. The predictive probabilities from the calibration curves had mean errors of 0.021 and 0.030, with ROC AUCs of 0.840 and 0.797 in the training and test sets, respectively.
CONCLUSION
Age, total cholesterol, pancreatitis history, pancreatic ductography, and bleeding influence the risk of acute PEP. A model incorporating these factors may aid early detection and intervention.
Core Tip: A predictive model of acute post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) was constructed based on age, total cholesterol, history of pancreatitis, pancreatic ductography, and bleeding. Its application in clinical settings allows for targeted and prophylactic treatments for different patients and reduces the risk of PEP in patients.
