Risk Factors for Adverse Events Following Endoscopic Retrograde Cholangiopancreatography (ERCP): Is the Invasiveness of the Procedure Related with Major Complications and Pancreatitis?

Abstract Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be a challenge in patients with surgically altered anatomy. We aimed to identify the risk factors of ERCP-related adverse events in patients with surgically altered anatomy in our center. Methods We included patients with surgically altered anatomy who underwent ERCP between April 2017 and December 2020 at our center. Clinical characteristics and outcomes were analyzed in univariate and multivariate methods to identify the risk factors for adverse events. Results A total of 121 ERCP procedures were performed in 93 patients. The papilla or surgical anastomosis was successfully reached in 113 cases (93.4%). Diagnostic success was achieved in 106 cases (93.8%) and subsequent therapeutic success was achieved in 102 cases (96.2%). ERCP-related adverse events occurred in 31 cases (25.6%). In univariate analysis, not first time ERCP attempt, a CBD stone diameter ≥ 15 mm, multiple cannulation attempts, endoscopic papillary balloon dilation, endoscopic papillary large balloon dilation, endoscopic retrograde biliary drainage, biopsy in the bile duct or papilla, mechanical lithotripsy use, and stone retrieval basket were associated with ERCP-related adverse events. In multivariate analysis, multiple cannulation attempts (OR 5.283; 95% CI 1.088–25.659; p = 0.039), endoscopic papillary balloon dilation (OR 4.381; 95% CI 1.191–16.114; p = 0.026), and biopsy in the bile duct or papilla (OR 35.432; 95% CI 2.693–466.104; p = 0.007) were independently associated with ERCP-related adverse events. Conclusions ERCP in patients with surgically altered anatomy was feasible and safe. Interventions including multiple cannulation attempts, endoscopic papillary balloon dilation, and biopsy in the bile duct or papilla were independent risk factors for ERCP-related adverse events.

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Risk Factors for Adverse Events Associated With Endoscopic Retrograde Cholangiopancreatography in Patients With Surgically Altered Anatomy: A Retrospective Study

10.21203/rs.3.rs-835539/v1 ◽

2021 ◽

Author(s):

Xiaojia Chen ◽

Fan Wang ◽

Jing Liu ◽

Zhang Zhang ◽

Tingting Cao ◽

...

Keyword(s):

Risk Factors ◽

Bile Duct ◽

Adverse Events ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Univariate Analysis ◽

Balloon Dilation ◽

Endoscopic Papillary Balloon Dilation ◽

Endoscopic Retrograde ◽

Therapeutic Success ◽

Surgically Altered Anatomy

Abstract Introduction : Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be a challenge in patients with surgically altered anatomy. We aimed to identify the risk factors of ERCP-related adverse events in patients with surgically altered anatomy in our center. Methods We included patients with surgically altered anatomy who underwent ERCP between April 2017 and December 2020 at our center. Clinical characteristics and outcomes were analyzed in univariate and multivariate methods to identify the risk factors for adverse events. Results A total of 121 ERCP procedures were performed in 93 patients. The papilla or surgical anastomosis was successfully reached in 113 cases (93.4%). Diagnostic success was achieved in 106 cases (93.8%) and subsequent therapeutic success was achieved in 102 cases (96.2%). ERCP-related adverse events occurred in 31 cases (25.6%). In univariate analysis, not first time ERCP attempt, a CBD stone diameter ≥ 15 mm, multiple cannulation attempts, endoscopic papillary balloon dilation, endoscopic papillary large balloon dilation, endoscopic retrograde biliary drainage, biopsy in the bile duct or papilla, mechanical lithotripsy use, and stone retrieval basket were associated with ERCP-related adverse events. In multivariate analysis, multiple cannulation attempts (OR 5.283; 95% CI, 1.088–25.659; p = 0.039), endoscopic papillary balloon dilation (OR 4.381; 95% CI, 1.191–16.114; p = 0.026), and biopsy in the bile duct or papilla (OR 35.432; 95% CI, 2.693-466.104; p = 0.007) were independently associated with ERCP-related adverse events. Conclusions ERCP in patients with surgically altered anatomy was feasible and safe. Interventions including multiple cannulation attempts, endoscopic papillary balloon dilation, and biopsy in the bile duct or papilla were independent risk factors for ERCP-related adverse events.

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Risk factors of adverse events in endoscopic retrograde cholangiopancreatography for patients aged ≥85 years

Geriatrics and Gerontology International ◽

10.1111/ggi.13302 ◽

2018 ◽

Vol 18 (7) ◽

pp. 1038-1045 ◽

Cited By ~ 3

Author(s):

Koji Takahashi ◽

Toshio Tsuyuguchi ◽

Harutoshi Sugiyama ◽

Junichiro Kumagai ◽

Masato Nakamura ◽

...

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Retrograde

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Efficacy of an Oxycodone-Propofol Combination versus a Fentanyl-Propofol Combination in Conscious Sedation during Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients

Gerontology ◽

10.1159/000511173 ◽

2020 ◽

pp. 1-8

Author(s):

Peipei Guo ◽

Huisheng Wu ◽

Lan Liu ◽

Qiu Zhao ◽

Zhao Jin

Keyword(s):

Adverse Events ◽

Elderly Patients ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Postoperative Nausea ◽

Recovery Time ◽

Adverse Reactions ◽

Conscious Sedation ◽

Endoscopic Retrograde ◽

Patients Satisfaction ◽

Low Incidence

Background: With a rapidly aging population, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. The commonly used sedation anesthesia in ERCP is a combination of propofol and fentanyl, even though fentanyl may cause some adverse reactions such as respiratory depression. Objectives: This study aimed to evaluate the efficacy of oxycodone combined with propofol versus fentanyl combined with propofol for sedation anesthesia during ERCP. Methods: A total of 193 patients aged from 65 to 80 years undergoing ERCP were enrolled and randomized into two groups: an “oxycodone combined with propofol” group (group OP, n = 97) and a “fentanyl combined with propofol” group (group FP, n = 96). The rate of perioperative adverse events as well as the recovery time, patients’ satisfaction, and endoscopists’ satisfaction were noted. Results: There was no difference in the frequency of hypotension or bradycardia between the two groups, but there were more episodes of desaturation (SpO2 <90% for >10 s in 8.3%), postoperative nausea (7.3%), and vomiting (5.2%) in group FP than in group OP. Patients’ satisfaction in group FP was lower than that in group OP. The recovery time was longer in group FP than in group OP. Conclusions: Oxycodone combined with propofol was effective in ERCP, with a low incidence of perioperative adverse events.

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