FREQUENCY OF EARLY POST-ERCP ADVERSE EVENTS IN BOTH DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Dure Nayab, Sana Ara Akhtar, Sher Rehman, Hafsa Habib

Abstract


Background: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for diagnosis and treatment of hepatobiliary disorders. However, there are many adverse events associated with this procedure. The objective of this study was to determine the frequency of early post-ERCP adverse events in both diagnostic and therapeutic procedures in our set-up.
Material & Methods: This cross-sectional study was conducted at Department of Gastroenterology, Hayatabad Medical Complex, Peshawar, Pakistan, from 20th December, 2016 to 20th January, 2017. Consecutive sampling technique was used. Patients undergoing ERCP whether diagnostic or therapeutic, irrespective of age and gender, were included. Those having evidence of pancreatitis, cholangitis, or previous ERCP, or abdominal surgery were excluded. The outcome was early post-ERCP complications including pancreatitis, cholangitis, bleeding and perforation. The patients were assessed for these complications immediately and 72 hours after the procedure. Demographic data like age and gender were recorded. The data regarding early post-ERCP complications were recorded and presented as frequencies.
Results: Total 102 patients were included in the study. Among these, 38(37.3%) were males and 64 (62.7%) females. Mean age of patients included was 50.89±15.67 years (range 8 to 90 years). Overall post-ERCP complications were noted in 6(5.88%) patients. The most common complication was cholangitis in 5(4.9%) patients, followed by pancreatitis in only one (0.98%). Bleeding and perforation occurred in none of our patients.
Conclusion: The most common Post-ERCP complication is cholangitis. Based on our findings, we suggest closer monitoring of patients undergoing ERCP for development of infection. Proper disinfection protocols should be followed to prevent infection.

Keywords


Common bile duct; Endoscopic retrograde, Cholangiopancreatography; Cholangitis; Pancreatitis.

Full Text:

PDF

References


Chandrasekhara V, Khashab MA, Muthusamy VR, Acosta RD, Agrawal D, Bruining DH, et al. Adverse events associated with ERCP. ASGE Standards of Practice Committee, Gastrointest Endosc 2017;85:32-47.

Freeman M. Complications of endoscopic retrograde cholangiopancreatography. Tech Gastrointest Endosc 2012;14:148-55.

Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med 1996;335:909-18.

Christensen M, Matzen P, Schulze S, Rosenberg J. Complications of ERCP: a prospective study. Gastrointest Endosc 2004;60:721-31.

Enns R, Eloubeidi MA, Mergener K, Jowell PS, Branch MS, Pappas TM, et al. ERCP-related perforations: risk factors and management. Endoscopy 2002;34:293-8.

Cotton P, Garrow DA, Gallagher J, Romaqnuolo J. Risk factors for complications after ERCP: a multivariate analysis of 11497 procedures over 12 years. Gastrointest Endosc 2009;70:80-8.

Khashab MA, Tariq A, Tariq U, Kim K, Ponor L, Lennon AM, et al. Delayed and unsuccessful endoscopic retrograde cholangiopancreatography are associated with worse outcomes in patients with acute cholangitis. Clin Gastroenterol Hepatol 2012;10:1157-61.

Balmadrid B, Kozarek R. Prevention and management of adverse events of endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am 2013;23:385-403.

Young Bang J, Cote GA. Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography. Tech Gastrointes Endosc 2014;16:195-201.

Rustagi T, Jamidar PA. Endoscopic retrograde cholangiopancreatography related adverse events: general overview. Gastrointest Endosc Clin N Am 2015;25:97-106.

Vandervoort J, Soetikno RM, Tham TC, Wong RC, Ferrari AP Jr, Montes H, et al. Risk factors for complications after performance of ERCP. Gastrointest Endosc 2002;56:652-6.

Rutala WA, Weber DJ. ERCP scopes: What can we do to prevent infections? Infect Control Hosp Epidemiol 2015;36:643-8.

Cotton PB, Connor P, Rawls E, Romagnuolo J. Infection after ERCP and antibiotic prophylaxis: a sequential quality-improvement approach over 11 years. Gastrointest Endosc 2008;67:471-5.

Othman MO, Guerrero R, Elhanafi S, Davis B, Hernandez J, Houle J, et al. A prospective study of the risk of bacteremia in directed cholangioscopic examination of the common bile duct. Gastrointest Endosc 2016;83:151-7.

Masci E, Toti G, Mariani A, Curioni S, Lomazzi A, Dinelli M, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol 2001;96:417-23.

Williams EJ, Taylor S, Fairclough P, Hamlyn A, Logan RF, Martin D, et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy 2007; 39:793-801.


Refbacks

  • There are currently no refbacks.


© 2011 Gomal Journal of Medical Sciences