Development and external validation of a model for post-endoscopic retrograde cholangiopancreatography pancreatitis.

Journal: iScience
Published Date: May 2, 2025

Abstract

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a common complication in patients undergoing ERCP for choledocholithiasis, yet effective predictive models are lacking. This study included 2,247 patients who underwent ERCP for complete stone removal at the First Affiliated Hospital of USTC from January 2015 to January 2023. Six machine learning algorithms were utilized, incorporating 25 clinical parameters, to develop a predictive model for PEP risk. The random forest (RF) algorithm achieved the highest accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.947 in the internal dataset. Key risk factors for PEP identified include difficult cannulation, a history of pancreatitis, smaller common bile duct diameter, and female gender. Validation with datasets from 12 external centers showed AUC values ranging from 0.576 to 0.913, with an average of 0.768. An interactive R Shiny web application was also developed, offering a user-friendly tool for predicting PEP risk and enabling individualized management.

Authors

  • Gang Wang
    National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
  • Qikai Sun
    Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, China.
  • Hai Zhu
  • Song Qiao
    Department of Outpatient, The First People's Hospital of Hefei, Hefei, Anhui 230031, China.
  • Peng Xu
    Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
  • Xiangyu He
    Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410000, China.
  • Xiangkun He
  • Xiaosi Hu
    Department of General Surgery, Anhui No.2 Provincial People's Hospital, Hefei, Anhui 230041, China.
  • Mingming Song
    Department of General Surgery, The Second People's Hospital of Hefei, Hefei, Anhui 230011, China.
  • Qiuyan Zhang
    Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China.
  • Zhenyu Feng
    Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
  • Yue Chen
    The College of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Yue Gao
    Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
  • Zhiyuan Jin
    Department of Pediatric Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 246400, China.
  • Wen Li
  • Haizheng Tang
    Department of General Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230031, China.
  • Chaoqun Yan
    Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Hai Yun Cang on the 5th Zip, Beijing, 100700, China.
  • Yajun Wei
    Department of General Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230031, China.
  • Shibo Xu
    Department of General Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230031, China.
  • Gang Hu
    Ping An Health Technology, Beijing, China.
  • Xiuhua Zhang
    Pharmaceutical Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
  • Jinxin Zheng
    School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
  • Cheng Wang
    Department of Pathology, Dalhousie University, Halifax, NS, Canada.

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