Su1586 OUTCOMES OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract

Background: There is limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with Inflammatory Bowel Diseases (IBD). Aim: The aim of this study is to assess safety and efficacy of the ERCP in IBD patients who underwent ERCP for a variety of reasons in a national inpatient data base. Method: The National Inpatient Sample (NIS) is the largest all-payer inpatient database consisting of approximately 20% of all inpatient admissions to nonfederal hospitals in the United States. Data from the years 2009 to 2014 were collected. Patients older than 18 years with a diagnosis of IBD who had undergone ERCP (nZ1519) were included. Case-control 2:1 matching was done based on gender, age, race and Charlson Comorbidity Index (CCI) for IBD patients. Complications and mortality were evaluated for IBD patients against case-controls. Results were adjusted via logistic regression analyses to obtain adjusted odds ratios (aOR) for different outcomes. IBM Statistical Package for the Social Sciences (SPSS) version 25 was used for statistical analysis. Results: Between 2009 and 2014 there were 1519 patients with IBD aged older than 18 years who had undergone an ERCP. Baseline patient demographics are presented in Table 1. Age, sex, CCI, and race were all matched without statistically significant differences between cases and controls. We used the binary logistic regression models for mortality and post ERCP complications. We found significant differences between IBD and non-IBD patients for post-ERCP pancreatitis (aOR 13.38, 95% CI 1.45-1.24) and post-ERCP Infection (aOR 1.21, CI 1.01-1.45). However, there was no significant differences between IBD and non-IBD patients for post-ERCP mortality (aOR 1.29, 95% CI 0.73-2.71), post-ERCP cholecystitis (aOR 2.11, 95% CI 0.76-5.84), post-ERCP perforation (aOR 4.01, 95% CI 0.36-44.27), or post-ERCP bleeding (aOR 0.72, 95% CI 0.28-1.83). Conclusion: IBD appears an independent risk factor for post-ERCP pancreatitis and post-ERCP infection. However, limitation of the study is that NIS is an administrative database which predisposes to errors from coding inaccuracies as well as obscurement of temporal relationships between outcomes and diseases. More prospective research would be useful to confirm our findings.

Endoscopic retrograde cholangiopancreatography outcomes in inflammatory bowel disease patients: a 12-year analysis of a national database

“…Additionally, previous literature is limited longitudinally with comparisons lasting only between three to six years at most. [6][7][8] Ascertaining if IBD is a risk factor for PEP and other post-ERCP complications will help stratify these patients into low or high-risk categories. Thus, in uencing if the prophylactic measures must be taken to help reduce the occurrence of PEP and other post-ERCP complications such as gastrointestinal (GI) bleeds, perforation, cholecystitis, and infections.…”