Intrapancreatic Fat Deposition and Risk of Post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis

OBJECTIVES: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of this procedure. Emerging evidence suggests that intrapancreatic fat deposition (IPFD) may influence susceptibility to PEP, and its impact on clinical severity remains unclear. This meta-analysis aimed to evaluate whether IPFD is associated with an increased risk and severity of PEP. METHODS: We systematically searched PubMed, Embase, and Cochrane Central databases to identify studies that compared patients who underwent ERCP with and without radiologically defined IPFD to investigate the incidence of PEP. Adjusted pooled odds ratios (ORs) with 95% CI were calculated to reduce confounding factors. Heterogeneity was assessed using the I2 statistic. RESULTS: Three studies involving 1950 patients were included. A significantly higher incidence of PEP was observed in patients with IPFD than in those without IPFD (OR: 3.07; 95% CI: 2.00-4.73; P