Zehra Naseem, MD1, Aun Muhammad, MD2 1Cleveland Clinic, Cleveland, OH; 2University of Mississippi Medical Center, Flowood, MS Introduction: While several studies have explored various risk factors linked to complications following Endoscopic Retrograde Cholangiopancreatography (ERCP), the impact of obesity on ERCP outcomes remains underexplored. In our study, we aimed to address this gap by comparing in-hospital outcomes of obese vs. non-obese patients undergoing ERCP for acute biliary pancreatitis and acute cholangitis. Methods: We performed a retrospective cohort study using the TrinNetX database, a comprehensive multi-institutional dataset. Adult patients undergoing ERCP for biliary acute pancreatitis and acute cholangitis from 1/1/2000 to 5/30/2025 were included. Patients with any history of chronic pancreatitis, pancreatic/biliary tract malignancy, primary biliary cirrhosis, and primary sclerosing cholangitis were excluded. Patients were categorized based on whether they had a BMI of ≥30 kg/m2 vs ≤30 kg/m2. The primary aim was to assess post-ERCP complications at 1 week post-procedure. 1:1 propensity score matching was applied for age, gender, race, tobacco and alcohol use, comorbidities, socioeconomic status, and severity of acute pancreatitis and cholangitis. Results: Following propensity matching, a total of 10,153 patients in each group were included in the analysis. Patients with obesity had a higher risk of post-ERCP pancreatitis, respiratory failure, intubation, intensive care unit admission, sepsis, shock, and acute kidney injury as compared to patients with no obesity (Table 1). Discussion: Our study demonstrated that patients with obesity undergoing ERCP for cholangitis and biliary pancreatitis may be associated with worse clinical outcomes when compared to patients without obesity. Therefore, BMI should be an important factor to consider when performing ERCP on patients with biliary pancreatitis and cholangitis.
Figure: Comparison of In-Hospital Outcomes in Patients with and without obesity Undergoing ERCP for Acute Biliary Pancreatitis and Acute Cholangitis
Disclosures: Zehra Naseem indicated no relevant financial relationships. Aun Muhammad indicated no relevant financial relationships.
Zehra Naseem, MD1, Aun Muhammad, MD2. P4307 - Impact of Obesity on In-Hospital Outcomes Following ERCP for Acute Biliary Pancreatitis and Cholangitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
