Ercp Performance in a Tertiary Brazilian Center: Focus on New Risk Factors, Complications and Quality Indicators

Borges, Alana Costa; Almeida, Paulo César de; Furlani, Stella Maria Torres; Cury, Marcelo de Sousa; Pleskow, Douglas K.

doi:10.1590/0102-672020180001e1348

Cited by 7 publications

(8 citation statements)

References 34 publications

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“…In this large study population, male preponderance was apparent and in accordance to a few local, 6 and international, 18 studies but in contrast to studies from Brazil, 19 India, 20 and the United Kingdom. 21 The mean age for our sample was 56 ± 16 years which was higher than a study by Jain et al 20 Approximately 79% of the patients had no co-morbidities that corresponded positively to the younger population and probably to a high success rate.…”

Section: Discussionsupporting

confidence: 88%

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

Kazmi

Khan

Alam

et al. 2022

PAFMJ

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Objective: To determine the demographics, indications and frequency of interventions and complications endoscopic retrograde cholangiopancreatography (ERCP). Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: The study included all the elective and emergency ERCP procedures from January 2019 to December 2019. Results: Out of 1030 patients who underwent endoscopic retrograde cholangio-pancreaticography, 903 were enrolled. Sixtyone percent of the participants were males. The mean age was 56 ± 16 years, with the majority of the patients lying in the age range of 41-65 years. The most common indication for ERCP in this study was choledocholithiasis (47%), the most common complication encountered was acute pancreatitis (2.1%), and a mortality rate of 0.2% was reported. The complication rate was statistically related to the intervention rather than the age and gender of the patients. Conclusion: The most common indication for ERCP remains choledocholithiasis, with the most common ERCP complication being acute pancreatitis followed by stent migration. Biliary fistulae, post-surgical biliary leaks and strictures, pancreatic pseudo cysts, acute cholangitis, choledocholithiasis and cholestasis secondary to as cariasis were found in a relatively younger group. The success rate was above 95% for high volume centres.

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Section: Discussionsupporting

confidence: 88%

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

Kazmi

Khan

Alam

et al. 2022

PAFMJ

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“…Worldwide, ERCP mortality ranges from 0 to 1.5% and can be caused by any complication. Mortality rate is generally high in therapeutic procedures [13]. In the study performed by Borges et al [13], infection rate after ERCP was reported as 3%, bacteremia rate as 0.5% and mortality rate as 1.5%.…”

Section: Discussionmentioning

confidence: 98%

“…Mortality rate is generally high in therapeutic procedures [13]. In the study performed by Borges et al [13], infection rate after ERCP was reported as 3%, bacteremia rate as 0.5% and mortality rate as 1.5%. In a 10-year retrospective study by Coelho-Prabhu et al [4], post-ERCP infection and 30-day mortality rates were 1.5% and 2.4%, respectively.…”

Section: Discussionmentioning

confidence: 98%

Risk factors for bacteremia following endoscopic retrograde cholangiopancreatography

Tümtürk¹,

Hatipoğlu²

2020

Journal of Surgery and Medicine

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Aim: Bacteremia after endoscopic retrograde cholangiopancreatography (ERCP) is a serious complication, but its risk factors have not yet been clearly defined. In this study, we aimed to determine the incidence of bacteremia and associated risk factors after ERCP. Methods: This retrospective-cohort study was conducted between January 2017 and December 2018. Patients who had no signs of infection before the procedure and who developed bacteremia after the procedure were included in the study. For each patient who developed bacteremia, two randomized control patients who underwent ERCP and did not develop bacteremia were selected to compare risk factors, clinical and laboratory findings. Results: A total of 91 bacteremia attacks were detected in 86 of the 4237 patients who underwent ERCP procedure. Bacteremia rate after ERCP was 2%. In multivariate analysis, the age of the patient, presence of biliary tract cancer, cholecystitis / cholangitis, pancreatitis and biopsy were determined as significant risk factors for post-ERCP bacteremia (P=0.009, P<0.001, P=0.008, P=0.002 and P=0.014 respectively). Conclusion: The development of bacteremia after ERCP significantly increases the risk of mortality. The mean age of the patients who died was older. This result supports the use of prophylactic antibiotics especially in elderly patients. We think that knowledge of potential ERCP complications and risk factors may help reduce the incidence and severity of complications.

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“…The risks associated with fistulotomy may be more relevant to techniques that involve pancreatic deep wire pass and repeated cannulation attempts. ESGE recommends needle-knife fistulotomy as the preferred technique for precutting [21], but it has been reported that fistulotomy is a risk factor for pancreatitis after ERCP [34]. The incidence of pancreatitis after ERCP in patients who used fistulotomy in Tae Hoon Lee’s study was 2.5% (3/120) [35].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Evidence from 1786 Cases

Wang

Fang

et al. 2018

Med Sci Monit

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BackgroundPostoperative pancreatitis is one of the most serious complications in endoscopic retrograde cholangiopancreatography (ERCP).To detect potential risk factors for post-ERCP hyperamylasemia and pancreatitis.Material/MethodsWe reviewed 1786 ERCP procedures in Zhongnan Hospital of Wuhan University from January 2015 to April 2018. Clinical data were extracted, and the complications after ERCP procedures were re-evaluated. Single- and multiple-variable analyses were conducted to detect the potential risk factors.ResultsWe found that 1786 procedures were applied on 1707 patients; 64 patients (3.58%) developed pancreatitis, while asymptomatic hyperamylasemia occurred in 263 cases (14.73%). In multivariate analysis, pancreatic deep wire pass (odds ratio [OR]: 2.280, 95% CI [confidence interval]: 1.129–4.605, P=0.022), endoscopic metal biliary endoprosthesis (OR: 2.399, 95% CI: 1.120–5.138, P=0.024), operation after liver transplantation (OR: 3.057, 95% CI: 1.110–8.422, P=0.031), and fistulotomy (OR: 3.148, 95% CI: 1.036–9.561, P=0.043) were identified as independent risk factors for post-ERCP pancreatitis. Pancreatic deep wire pass (OR: 1.678, 95% CI: 1.136–2.478, P=0.009), fistulotomy (OR: 2.553, 95% CI: 1.096–5.948, P=0.030), and younger age (OR: 0.990, 95% CI: 0.980–0.999, P=0.037) were identified as independent risk factors for hyperamylasemia.ConclusionsTo prevent post-ERCP pancreatitis, it is important to avoid high-risk procedures such as fistulotomy and pancreatic deep wire pass, especially in high-risk patients with liver transplantation. For patients with endoscopic metal biliary endoprosthesis, clinicians should pay more attention to the occurrence of post-ERCP pancreatitis.

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Ercp Performance in a Tertiary Brazilian Center: Focus on New Risk Factors, Complications and Quality Indicators

Cited by 7 publications

References 34 publications

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

Risk factors for bacteremia following endoscopic retrograde cholangiopancreatography

Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: Evidence from 1786 Cases

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