Endoscopic Retrograde Cholangiopancreatography Outcomes in Inflammatory Bowel Disease Patients: A 12 -Year Analysis of a National Database

Abstract

Background: Despite inflammatory bowel’s disease’s (IBD) association with hepatobiliary disorders and the use of endoscopic retrograde cholangiopancreatography (ERCP) for both diagnostic and therapeutic evaluation of these diseases, it remains a poorly studied area within the literature. The purpose of this study is to examine the effect of IBD on the occurrence of adverse events (AE) pertaining to ERCP. Methods: This project utilized the National Inpatient Sample (NIS) database, the largest inpatient database in the United States. All patients 18 years or older with and without IBD undergoing ERCP were identified from 2008 to 2019. Post-ERCP AEs were analyzed using multivariate logistic or linear regression controlling for age, race, and existing comorbidities using the Charlson comorbidity index (CCI). Results: There was no difference in post-ERCP pancreatitis (PEP) or mortality. IBD patients were also found to have a lower risk of bleeding and decreased length of stay (LOS) despite adjustment for co-morbidities. Subgroup analysis between ulcerative colitis (UC) and Crohn’s disease (CD) did not find any significant differences in outcomes. Conclusion: To our knowledge, this is the largest study to date evaluating ERCP outcomes in IBD patients. After adjustment of co-variates, there was no difference in the occurrence of PEP, infections and perforation. IBD patients were less likely to experience post-ERCP bleeding, mortality and LOS.