Risk factors of post‐ endoscopic retrograde cholangiopancreatography pancreatitis in biliary type sphincter of Oddi dysfunction in Japanese patients

Matsuda, Hiroyuki; Matsumoto, Satohiro; Mashima, Hirosato

doi:10.1111/1751-2980.12541

Cited by 8 publications

(2 citation statements)

References 41 publications

(97 reference statements)

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“…Endoscopic retrograde cholangiopancreatography (ERPC) procedure is used for the diagnosis and treatment of pancreatic and hepatobiliary diseases. However, complications following ERCP require specific attention and clinical practice guideline especially when ERCP is performed in liver cancer treatment patients owing to their biliary complications (8)(9)(10). If patients with liver cancer experience biliary problems following a successful liver transplant, ERCP is regarded as the gold standard treatment (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of endoscopic retrograde cholangiopancreatography in previously treated liver cancer patients: a survival analysis

Li¹,

Jia

et al. 2023

Front. Oncol.

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Background and AimThe prognosis and medication response for liver malignancies are both dismal and highly heterogeneous. For this diverse malignancy, multimodality therapies such as drugs, surgical management, and/or l+iver transplantation are available. Biliary complications remain a major problem after liver cancer treatment especially in those patients who undergo liver transplantation for their end stage liver disease. Although, most biliary complications can be successfully managed with endoscopic retrograde cholangiopancreatography. However, biliary complications still considered an important factor influencing long-term results in liver cancer treatment patients. The aim of this study was to evaluate the effect of biliary complications on the overall patient’s survival rate after the endoscopic retrograde cholangiopancreatography.Patients and MethodsWe retrospectively analyzed data of consecutive patients who were treated for liver cancer at our tertiary care hospital from January 2015 to July 2020. We focused on the biliary complications and procedural data, including post-endoscopic retrograde cholangiopancreatography complications, survival rate, and complementary or alternative treatments to endoscopic retrograde cholangiopancreatography.ResultsWe identified 967 cases (mean age 49; range 11-75), 84% men. During the mean follow up of 25 months (range 1 to 66 months), 102 patients developed biliary complications; 68/102 underwent 141 therapeutics endoscopic retrograde cholangiopancreatography procedures. The rest 34/102 patients were managed with percutaneous transhepatic cholangiography, conservative management, and/or surgery. Post- endoscopic retrograde cholangiopancreatography complications occurred in 79.4%, including anastomotic strictures in 25, non-anastomotic strictures in 5, stones in 5, cholangitis in 4, post-sphinctretomy bleeding in 3, pancreatitis in 2, and bile leakage in 1 patient. Seven (13.0%) patients died after ERCP due to multiple organ dysfunction syndrome. Although the survival rate of patients who underwent ERCP and those without ERCP was similar, patients with biliary complications fared significant worse.ConclusionAlthough endoscopic retrograde cholangiopancreatography is useful for the management of post liver cancer treatment biliary complications; the need for multiple rounds of endoscopic retrograde cholangiopancreatography and even post endoscopic retrograde cholangiopancreatography complications is relatively high, and often results in increased mortality. However, the survival following endoscopic or surgical therapy in liver cancer treatment patients is similar.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of endoscopic retrograde cholangiopancreatography in previously treated liver cancer patients: a survival analysis

Li¹,

Jia

et al. 2023

Front. Oncol.

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“…Therefore, knowledge about the risk factors enables proper risk assessment and selection of the best treatment options. Previous studies have analyzed over 56 risk factors, but even in the most extensive studies conducted, only four of them have been repeated (sphincter of Oddi dysfunction, female sex, pre-cut incision, and unintentional contrast filling of the duct of Wirsung) [1,[3][4][5][6][7][8][9]. Therefore, it is likely that the importance of already identified risk factors has not been clearly evaluated, and not all risk factors have been probably identified.…”

Section: Introductionmentioning

confidence: 99%

Flat Papilla of Vater and Bleeding during Endoscopic Sphincterotomy: Two New Risk Factors for Post-Endoscopic Pancreatitis

Jamry¹

2021

austinjsurg

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Objective: To analyze the risk factors for post-endoscopic pancreatitis (PEP). Background: PEP occurs in 4%-42% of patients, depending on their risk factors. Over 56 risk factors were analyzed, but only 4were found to be repeated in most studies. Study: A single-center retrospective study analyzing 402 consecutive patients with naïve papillae who underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) was conducted. The significance of 14 potentially new risk factors was evaluated, and it was found that they were associated with the level of bile duct stenosis, papilla anatomy, bleeding during sphincterotomy, endoscopic bleeding control, and pathological examination. Furthermore, 13 of the most frequently published risk factors were re-analyzed. Results: Five risk factors (containing two new ones) were significant with the following univariate and multivariate regression values: flat papilla (odds ratio [OR] 5.1, p=0.0049; OR 4.59, p=0.0244) and bleeding during endoscopic sphincterotomy (OR 3.58, p=0.148; OR 4.07, p=0.0257), and significance of the three already known risk factors was confirmed: age <40 years (OR 6.89, p=0.0139; OR 4.96, p=0.0139), common bile duct (CBD) diameter < 9 mm (OR 5.35, p=0.0007; OR 3.98, p=0.0203), and difficulty in cannulation (OR 3.2, p=0.0298; OR 7.72, p=0.004). Conclusion: This study reaffirms the risk of PEP associated with age, difficulty in cannulation, and CBD diameter. It also identifies two new risk factors: flat papilla and bleeding during sphincterotomy. These results suggest the need for a change in ERCP methodology in patients with these risk factors, but this finding requires confirmation in subsequent studies.

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Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis

Park

Yang

et al. 2021

Surg Endosc

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Risk factors of post‐ endoscopic retrograde cholangiopancreatography pancreatitis in biliary type sphincter of Oddi dysfunction in Japanese patients

Abstract: PGW technique and EST for biliary type SOD were important risk factors for PEP. Pancreatic stenting was ineffective for prevention of PEP.

Cited by 8 publications

References 41 publications

Safety and efficacy of endoscopic retrograde cholangiopancreatography in previously treated liver cancer patients: a survival analysis

Safety and efficacy of endoscopic retrograde cholangiopancreatography in previously treated liver cancer patients: a survival analysis

Flat Papilla of Vater and Bleeding during Endoscopic Sphincterotomy: Two New Risk Factors for Post-Endoscopic Pancreatitis

Pre- and post-procedure risk prediction models for post-endoscopic retrograde cholangiopancreatography pancreatitis

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