RESEARCH COMMUNICATION Risk Factors for Post-ERCP Cholangitis in Patients with Pancreatic Cancer from a Single Referral Center in Iran

Cholangitis is relatively uncommon (Boey & Way, 1980). Any condition that leads to stasis or obstruction of bile in the common bile duct (CBD), including benign or malignant stricture, parasitic infection, or extrinsic compression by the pancreas, can result in bacterial infection and cholangitis (Lam et al., 1978; Boey & Way, 1980). Choledocholithiasis is the most common cause of acute cholangitis, followed by endoscopic retrograde cholangiopancreatography [ERCP], and tumors. After ERCP 1-3% of patients develop cholangitis (O’Connor et al., 1982a: 1982b). Obstruction of the bile duct by tumor or stones can facilitate bacterial colonization; subsequent instrumentation has resulted in bacteremia rates mean 18.0% (O’Connor et al., 1982a: 1982b; Gerecht et al., 1989). The highest bacteremia rates are seen in therapeutic ERCP (Gerecht et al., 1989). In purely diagnostic ERCP, the bacteremic rate is lower at 8% (O’Connor et al., 1982b; Gerecht et al., 1989). Partial obstruction is associated with a higher rate of infection than complete obstruction (Boey & Way, 1980; Lam et al., 1978). Risk of cholangitis is increased if dye is injected retrograde (Boey & Way, 1980). Mortality of cholangitis is high due to the predisposition