Pain Score within Twenty-Four Hours Post-Endoscopic Retrograde Cholangiopancreatography: A Comparison between Diagnostic and Therapeutic Procedures

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure and can produce moderate to severe abdominal pain. Limited information is available regarding pain assessment after the procedure. This study aims to compare the pain scores between diagnostic and therapeutic procedures within 24 hours post-ERCP in adult patients. We prospectively analyzed the patients who underwent ERCP from February to November 2007. Pain scores and pain medications used at 2, 6, 12, 18, and 24 hours post-procedure were studied. One hundred and seventy-seven patients, 29 with a diagnostic ERCP (group D) and 148 with a therapeutic ERCP (group T), were enrolled. The mean pain scores at baseline were not significantly different between the two groups. The mean pain scores at two and six hours post-ERCP in group T were significantly higher than in group D (P=0.035 and 0.020, respectively). The scores at the other periods of time in both groups were not significantly different. The total dose of pethidine used for pain control after ERCP in both groups was not significantly different. In conclusion, ERCP-induced abdominal pain mainly occurs within six hours after the procedure. Therapeutic ERCP has a higher pain score than that of diagnostic ERCP only at two and six hours post-ERCP.