Post-ERCP Complication Analysis of an Experienced Center

Abstract

Background/Aim: Post-ERCP pancreatitis (PEP), post-sphincterotomy bleeding (PSB), and Post-ERCP perforation are the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Identification of risk factors for post-ERCP complications is critical for postoperative follow-up. This study aimed to evaluate the most common post-ERCP complication risk factors in an experienced center. Methods/Design: The sample consisted of 1288 patients with naive papillae. Demographic characteristics, patient-related risk factors, procedure-related risk factors and postoperative complications were recorded. Results: Patients had a mean age of 61.5±18.4 years. The prevalence of PEP, PSB, and post-ERCP perforation was 7.9%, 11.9%, and 0.5%, respectively. Among patient-related factors, female sex (OR 1.672 95% Cl 1.046 to 2.672) and narrowing of the choledochal diameter (OR 2.910 95% Cl 1.830 to 4.626) were associated with PEP. From procedure-related factors; precut sphincterotomy (OR 2.172 95% Cl 1.182 to 3.994), difficult cannulation (OR 5.110 95% Cl 2.731 to 9.560), pancreatic cannulation (OR 5.692 95% Cl 0.994 to 32.602) and postprocedure residual stone (OR 2.252 95% Cl 1.403 to 3.614) were found to be associated with PEP. The successful procedure (OR 0.378 95% Cl 0.204 to 0.699) had a protective effect on PEP. Choledocholithiasis indication (OR 3.594 95% Cl 1.444 to 8.942) and small papilla (OR 2.042 95% Cl 1.170 to 3.562) were associated with the development of PSB. Choledochal stenosis, periampullary-diverticulum, oral anticoagulant, and oral antiaggregant use were not associated with the development of PSB. Of the patients with post-ERCP perforation, 85.7% had difficult cannulation, 57.1% had precut sphincterotomy, and 28.6% had periampullary-diverticulum. Conclusion: Female sex, biliary stricture, precut sphincterotomy, difficult cannulation, pancreatic cannulation, and postoperative residual stone were associated with PEP. Choledocholithiasis indication and the presence of small papilla were associated with PSB.

Endoscopic treatment of choledocholithiasis: effectiveness and complications

“…Хоча ЕРХПГ досить безпечна процедура, але у деяких випадках вона може призводити до розвитку ускладнень. За різними даними їх частота становить від 0,5 до 15% [11][12][13]. Згідно нашим даним ускладнення мали місце у 5,7%.…”

“…Незважаючи на високу ефективність ендоскопічного лікування холедохолітіазу, у 1,5-13% паціентів після ЕРХПГ та ендоскопічних втручаннь мають місце ускладнення [11][12][13] Результати. Основні вихідні показники хворих представлені у таблиці 1.…”

Pure cut vs. Endocut in endoscopic biliary sphincterotomy: Systematic review and meta-analysis of randomized clinical trials

“…Endoscopic biliary sphincterotomy is a crucial step in endoscopic retrograde cholangiopancreatography (ERCP), a procedure known to carry a 5-10% risk of complications, including post-ERCP pancreatitis (PEP), bleeding, cholangitis, perforation, sepsis, and even death [1,2,3,4,5]. Two commonly used current modes in sphincterotomy are pure cut and Endocut (or pulsed cut) [6,7,8].…”

SII in combination with hsCRP predict the risk of pancreatitis after endoscopic retrograde cholangiopancreatography

“…Endoscopic retrograde cholangiopancreatography (ERCP) is an effective treatment for biliary and pancreatic diseases, which has the advantages of rapid postoperative recovery, minimal trauma and low cost [1] .Although ERCP has developed into a mature minimally invasive intervention, as an invasive diagnostic and treatment technique, its postoperative complications are still di cult to avoid [2,3] .Studies show that pancreatitis is one of the most common complications after ERCP, with an incidence rate of 4% to 9.7% [4] .Post-ERCP Pancreatitis (PEP) puts a huge medical burden on the patients and society, so early prediction and targeted treatment of PEP is essential [5] .…”