ERCP-related adverse events in patients with primary sclerosing cholangitis

Navaneethan, Udayakumar; Jegadeesan, Ramprasad; Nayak, Shishira; Lourdusamy, Vennisvasanth; Sanaka, Madhusudhan R.; Vargo, John J.; Parsi, Mansour A.

doi:10.1016/j.gie.2014.06.030

Cited by 55 publications

(73 citation statements)

References 26 publications

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“…The reported incidence of complications associated with ERC in PSC is 4-18%. [196][197][198][199][200][201] In one of three studies that had a control group the incidence of complications was increased compared to patients without PSC. 201 This justifies an approach whereby ERC is undertaken by the most experienced available operator.…”

Section: Dominant Stricturesmentioning

confidence: 99%

Primary sclerosing cholangitis – a comprehensive review

Karlsen

Folseraas

Thorburn

et al. 2017

Journal of Hepatology

602

603

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Primary sclerosing cholangitis (PSC) is a rare disorder characterised by multi-focal bile duct strictures and progressive liver disease. Inflammatory bowel disease is usually present and there is a high risk of cholangiocarcinoma and colorectal cancer. Most patients ultimately require liver transplantation, after which disease recurrence may occur. With limited therapeutic options and a lack of proven surveillance strategies, patients currently have significant unmet needs. In the present seminar, we provide a comprehensive review of the status of the field. We emphasise developments related to patient stratification and disease behaviour, and provide an overview of management options from a practical, patient-centered perspective. We survey advances made in the understanding of PSC pathogenesis and summarise the ongoing efforts to develop an effective therapy based on these insights.

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Section: Dominant Stricturesmentioning

confidence: 99%

Primary sclerosing cholangitis – a comprehensive review

Karlsen

Folseraas

Thorburn

et al. 2017

Journal of Hepatology

602

603

View full text Add to dashboard Cite

show abstract

“…Several studies have evaluated the risk of complications in PSC patients undergoing ERCP (63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74). ERCP carries an increased risk for complications in the context of PSC, especially pancreatitis, cholangitis and extravasation of contrast, although not all the studies were documented such an increased risk in PSC (69,74).…”

Section: Esge/easl Suggest That Ercp In Psc Patients Should Be Undertmentioning

confidence: 99%

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

Aabakken¹,

Karlsen²,

Albert³

et al. 2017

Journal of Hepatology

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“…However, available literature suggests that the risk of post-ERCP complications is not elevated. Post-ERCP pancreatitis is reported to occur in 1.2-5%, while cholangitis occurs in 1-2.4% under perioperative broad-spectrum antibiotics [11][12][13] .…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

Ponsioen¹

2015

Dig Dis

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According to recent guidelines, primary sclerosing cholangitis (PSC) is diagnosed when a patient has a cholestatic liver enzyme profile, characteristic bile duct changes on imaging, and when secondary causes of sclerosing cholangitis are excluded. In patients with a clinical suspicion but normal cholangiography, a liver biopsy is indicated to establish a diagnosis of small duct PSC. Several other disease entities such as IgG4-associated cholangitis (IAC), cholangiocarcinoma (CCA), and secondary causes of sclerosing cholangitis such as choledocholithiasis, AIDS-cholangiopathy, ischemia, surgical bile duct trauma, or mast cell cholangiopathy can mimic PSC. IAC can be differentiated from PSC by applying the HISORt criteria including the serum IgG4 level. In cases where serum IgG4 is less than 2 × ULN, the ratio of IgG4/IgG1 >0.24 is indicative for IAC. Choledocholithiasis with recurrent cholangitis as a cause of sclerosing cholangitis can pose a conundrum, since PSC itself is associated with an increased prevalence of gallstones. The epidemiology of PSC worldwide has been poorly described. Incidence and prevalence rates vary from 0-1.3 and 0-16.2 per 100,000 inhabitants respectively. However, these figures are not based on population-based cohorts. A recent large population-based cohort from the Netherlands reported an incidence of 0.5 and a prevalence of 6/100,000. Approximately 10% fulfil the criteria for small duct PSC. At diagnosis of PSC, concurrent inflammatory bowel disease (IBD), primarily ulcerative colitis or Crohn's colitis is present in 50%, but increasing to 80%, 10 years or more after diagnosis. Conversely, 3% of IBD patients will develop PSC. PSC predisposes to malignancy. The estimated cumulative risk of developing CCA after 30 years is 20%. For colorectal carcinoma in PSC/colitis patients, the estimated cumulative risk at 30 years is 13%.

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ERCP-related adverse events in patients with primary sclerosing cholangitis

Cited by 55 publications

References 26 publications

Primary sclerosing cholangitis – a comprehensive review

Primary sclerosing cholangitis – a comprehensive review

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

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