Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography - Original Article

Q: What complication does the prediction model target in this study?

The model targets acute pancreatitis occurring after endoscopic retrograde cholangiopancreatography (post-ERCP pancreatitis, PEP).

Q: How were the patients grouped for model development and evaluation?

Patients were retrospectively divided into non-PEP (n = 159) and PEP (n = 24) groups based on whether PEP developed. For modeling, 70% were used for training and 30% for testing in R.

Q: Which factors were independently associated with acute PEP?

Independent associations included age, total cholesterol level, history of pancreatitis, pancreatic ductography, and bleeding.

Sep 28, 2026

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Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is a common procedure-related complication, and effective prevention remains a key clinical research focus. The study aimed to develop and assess a prediction model for post-ERCP pancreatitis (PEP) using multidimensional clinical indicators. A retrospective analysis compared non-PEP and PEP groups, evaluated PEP-associated factors via univariate and multivariate logistic regression, and assessed performance with calibration and ROC AUC.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Aim

Methods

Results

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Introduction

| W | J | G | S | World Journal of
Gastrointestinal Surgery | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Surg 2025 December 27; 17(12): 111003 DOI: 10.4240/wjgs.v17.i12.111003 ISSN 1948-9366 (online) ORIGINAL ARTICLE Retrospective Study Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators Xun-Xun Cao, Min Sun Specialty type: Gastroenterology and hepatology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B Novelty: Grade C Creativity or Innovation: Grade B Scientific Significance: Grade C P-Reviewer: Rhodin KE, Associate Professor, United States Received: June 24, 2025 Revised: July 28, 2025 Accepted: October 20, 2025 Published online: December 27, 2025 Processing time: 183 Days and 23.7 Hours Xun-Xun Cao, Min Sun, Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China 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.](China. sunminnt820919@163.com)[ sunminnt820919@163.com](China. sunminnt820919@163.com) 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 WJGS [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025 Volume 17 Issue 12 Cao XX et al. Predictive modeling of post-ERCP pancreatitis 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. Key Words: Pancreatitis; Multidimensional indicators; Endoscopic retrograde cholangiopancreatography; Model prediction; Logistic regression; Pancreatic ductography ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. Core Tip: A predictive model of acute post-endoscopic

FAQs

What complication does the prediction model target in this study?

The model targets acute pancreatitis occurring after endoscopic retrograde cholangiopancreatography (post-ERCP pancreatitis, PEP).

How were the patients grouped for model development and evaluation?

Patients were retrospectively divided into non-PEP (n = 159) and PEP (n = 24) groups based on whether PEP developed. For modeling, 70% were used for training and 30% for testing in R.

Which factors were independently associated with acute PEP?

Independent associations included age, total cholesterol level, history of pancreatitis, pancreatic ductography, and bleeding.

Sep 28, 2026

Uploaded by Bulrr