scholarly journals Identification of risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in a high volume center

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0177874 ◽  
Author(s):  
Veit Phillip ◽  
Miriam Schwab ◽  
David Haf ◽  
Hana Algül
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojia Chen ◽  
Fan Wang ◽  
Jing Liu ◽  
Wenhui Tao ◽  
Zhang Zhang ◽  
...  

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.


2019 ◽  
Vol 7 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Shinichi Takano ◽  
Mitsuharu Fukasawa ◽  
Hiroko Shindo ◽  
Ei Takahashi ◽  
Sumio Hirose ◽  
...  

Gut and Liver ◽  
2013 ◽  
Vol 7 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Min-Sun Kwak ◽  
Eun Sun Jang ◽  
Ji Kon Ryu ◽  
Yong-Tae Kim ◽  
Yong Bum Yoon ◽  
...  

2018 ◽  
Vol 26 (3) ◽  
pp. 176-183
Author(s):  
David N. Perdigoto ◽  
Dário Gomes ◽  
Nuno Almeida ◽  
Sofia Mendes ◽  
Ana Rita Alves ◽  
...  

2020 ◽  
Vol 38 (6) ◽  
pp. 534-541 ◽  
Author(s):  
Júlio Carlos Pereira Lima ◽  
Ivan David Arciniegas Sanmartin ◽  
Bruna Latrônico Palma ◽  
Carlos Eduardo Oliveira dos Santos

<b><i>Background:</i></b> Risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) complications are well-studied. However, risk factors for complications and success after endoscopic sphincterotomy (EST) for duct stones are poorly determined. This study aimed to verify risk factors for mortality, complications, and success after EST. <b><i>Methods:</i></b> A multivariate analysis was carried out in a dataset of ERCPs performed during 17 years. <b><i>Results:</i></b> A total of5,226 ERCPs were performed, of which 2,137 were in patients with bile duct stones (1,458 women and 679 men; mean age = 57 years) who underwent EST with attempted stone removal. There were 171 (8%) complications, with pancreatitis in 87 (4.1%), bleeding in 48 (2.2%), other complications in 36 (1.8%), and mortality of 0.6%. Successful stone(s) removal was obtained in 2,028 cases (94.9%). On multivariate analysis, mortality was associated with age &#x3e;60 years (1 vs. 0.2%), cholangitis (4.3 vs. 0.3%), and EST-related complications (5.8 vs. 0.2%). Complications were associated with unsuccessful stone removal (13.4 vs. 7.5%) and difficult cannulation (13.9 vs. 5.4%). An unsuccessful EST was independently related to difficult cannulation (86.2 vs. 98.7%), precutting (79.4 vs. 96.4%), and complications (86.5 vs. 95.6%). <b><i>Conclusions:</i></b> Risk factors for complications after EST for stones are delayed bile duct cannulation and failed stone retrieval. Mortality is higher in older patients, those who presented with an EST-related complication, or those who presented initially with cholangitis. Difficult cannulation, EST-related complications, and precutting were associated with an unsuccessful procedure. In this series, outpatient EST with attempted stone retrieval was found to be as safe as performing the procedure in hospitalized patients.


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