Risk factors for bleeding in patients with acute necrotizing pancreatitis undergoing endoscopic necrosectomy

Abstract Background Endoscopic necrosectomy (EN) has become the preferred necrosectomy approach in patients with acute necrotizing pancreatitis (ANP). Bleeding is a common complication of EN, but the risk factors for bleeding remain unclear. This study investigated risk factors for bleeding in patients with ANP undergoing EN and the effect of endoscopic haemostasis. Methods In total, 145 patients with ANP who underwent EN at a tertiary hospital were recruited from January 2014 to December 2018. Patients with and without bleeding during and within 24 h after EN were allocated to the bleeding and nonbleeding groups, respectively. Multivariable logistic regression models were used to assess independent risk factors for bleeding. Results Thirty-nine patients (26.9%) experienced bleeding. The body mass index and culture-confirmed infectious pancreatic necrosis (IPN), renal failure and continuous renal replacement therapy rates were significantly higher in the bleeding group (all P  Conclusion Renal failure, culture-confirmed IPN, and multiple debridement procedures were identified as independent risk factors for bleeding in patients with ANP who underwent EN.