We have located links that may give you full text access.
Comparative Study
Journal Article
Comorbidities, sphincterotomy, and balloon dilation predict post-ERCP adverse events in PSC patients: operator experience is protective.
Digestive Diseases and Sciences 2011 December
BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease. Interventional ERCP improves survival in PSC patients.
AIMS: To describe the frequency and risk factors for post-ERCP adverse events in patients with PSC via multivariate analysis.
METHODS: Retrospective cohort study included patients with a diagnosis of PSC who underwent ERCP at academic institutions between February 2000 and October 2009. Demographis, co-morbid conditions, antibiotic use, cannulation method, ERCP maneuvers and 30-day post-ERCP adverse events were collected. Multivariate analysis was performed using logistic regression.
RESULTS: A total of 185 procedures were performed on 75 PSC patients (58 M,17 F). Seven endoscopists performed ERCPs. Comorbidies included ulcerative colitis (44%, n = 33), Crohn's disease (12%, n = 9 patients), Cirrhosis (8%, n = 6 patients) and autoimmune hepatitis (2.7%, n = 2). Cannulation was achieved using dye-free guidewire cannulation techniques in 139/185 procedures (76%) and with contrast-based techniques in 46/185 procedures (24%). Thirty-day post-ERCP adverse events included post-ERCP pancreatitis (5%, n = 9, cholangitis (1%, n = 2), acute cholecystitis (0.5%, n = 1), stent occlusion (0.5%, n = 1), stent migration (0.5%, n = 1), and bile leak (0.5%, n = 1). In the multivariate analysis, associations with specific endoscopists who performed the procedure (P = 0.01), biliary dilation (P = 0.02), sphincterotomy (P = 0.03), presence of cirrhosis (P = 0.05), Crohn's disease (P < 0.001), and autoimmune hepatitis (P < 0.001) significantly predicted a complication following ERCP. Gender, stenting during procedure, presence of a dominant stricture, and cholangitis were not predictive for post-ERCP adverse events.
CONCLUSIONS: Factors predicting 30-day post-ERCP adverse events included certain co-morbid conditions, the endoscopist ERCP volume, maneuvers during ERCP including dilation and sphincterotomy. Stenting was not associated with adverse events.
AIMS: To describe the frequency and risk factors for post-ERCP adverse events in patients with PSC via multivariate analysis.
METHODS: Retrospective cohort study included patients with a diagnosis of PSC who underwent ERCP at academic institutions between February 2000 and October 2009. Demographis, co-morbid conditions, antibiotic use, cannulation method, ERCP maneuvers and 30-day post-ERCP adverse events were collected. Multivariate analysis was performed using logistic regression.
RESULTS: A total of 185 procedures were performed on 75 PSC patients (58 M,17 F). Seven endoscopists performed ERCPs. Comorbidies included ulcerative colitis (44%, n = 33), Crohn's disease (12%, n = 9 patients), Cirrhosis (8%, n = 6 patients) and autoimmune hepatitis (2.7%, n = 2). Cannulation was achieved using dye-free guidewire cannulation techniques in 139/185 procedures (76%) and with contrast-based techniques in 46/185 procedures (24%). Thirty-day post-ERCP adverse events included post-ERCP pancreatitis (5%, n = 9, cholangitis (1%, n = 2), acute cholecystitis (0.5%, n = 1), stent occlusion (0.5%, n = 1), stent migration (0.5%, n = 1), and bile leak (0.5%, n = 1). In the multivariate analysis, associations with specific endoscopists who performed the procedure (P = 0.01), biliary dilation (P = 0.02), sphincterotomy (P = 0.03), presence of cirrhosis (P = 0.05), Crohn's disease (P < 0.001), and autoimmune hepatitis (P < 0.001) significantly predicted a complication following ERCP. Gender, stenting during procedure, presence of a dominant stricture, and cholangitis were not predictive for post-ERCP adverse events.
CONCLUSIONS: Factors predicting 30-day post-ERCP adverse events included certain co-morbid conditions, the endoscopist ERCP volume, maneuvers during ERCP including dilation and sphincterotomy. Stenting was not associated with adverse events.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app