关键词: 内镜逆行胰胆管造影术, 胆总管结石, 高淀粉酶血症, 影响因素

Abstract: Objective To analyze the influencing factors for hyperamylasemia after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct stones.Methods A total of 246 hospitalized patients with common bile duct stones who underwent ERCP in our hospital from January 2023 to December 2024 were retrospectively enrolled and divided into occurrence group and non-occurrence group according to whether hyperamylasemia occurred postoperatively.Logistic regression was used to identify the influencing factors for hyperamylasemia after ERCP in patients with common bile duct stones, and a logistic regression equation model was established.Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.Receiver operating characteristic (ROC) curve, calibration curve, and decision curve were used to evaluate the model performance.Results Logistic regression analysis showed that female gender, history of alcohol consumption, triglycerides, common bile duct stenosis, difficult cannulation, and procedure time were risk factors for hyperamylasemia after ERCP in patients with common bile duct stones, while pancreatic duct stent was a protective factor (P<0.05).logit(P) =-6.406+1.094×female (yes=1, no= 0) + 0.866 × history of alcohol consumption (yes=1, no=0)+1.704×triglycerides (mmol/L)+0.863×common bile duct stenosis (yes=1, no=0)+1.009×difficult cannulation (yes=1, no=0) -1.042×pancreatic duct stent placement (yes=1, no=0)+0.075×procedure duration (min).The ROC curve showed that the area under the curve (AUC) of this model prediction was 0.848, with a specificity of 84.48% and a sensitivity of 73.61%.The concordance index after internal validation of the model obtained by Bootstrap method was 0.850.The calibration curve showed that the predicted values were close to the actual values.Hosmer-Lemeshow test showed χ2=3.344, P=0.911, indicating good consistency and goodness of fit.Decision curve analysis showed that the model had good standardized net benefit when the threshold probability value was 0.15-0.95.Conclusion Female gender, history of alcohol consumption, triglycerides, common bile duct stenosis, difficult cannulation, procedure time, and pancreatic duct stent are influencing factors for hyperamylasemia after ERCP in patients with common bile duct stones.The logistic regression prediction model constructed based on the above key parameters has excellent discriminative ability.

Key words: endoscopic retrograde cholangiopancreatography, common bile duct stones, hyperamylasemia, influencing factors