Evaluation of the Causes for Repeated Endoscopic Retrograde Cholangiopancreatography in the Early Period
Year: 2021
Type: article
Study design: Observational Study
Abstract: Objective: Endoscopic retrograde cholangiopancreatography (ERCP) is the most important invasive endoscopic procedure for the clearance of bile duct stones.Several factors may interfere with a positive outcome in the first attempt.It is important for the endoscopist and the patient to predict under which circumstances repeated intervention may be required.The aim of this study was to determine the conditions in which the need for repeated ERCP increases in patients who have undergone ERCP for bile duct stones.Methods: Data collected from the procedures performed by a single endoscopist between 2005 and 2020 were analyzed retrospectively.The findings obtained from 100 cases whose bile duct stones were cleared in a single procedure were compared with those of 100 cases who required repeated ERCP in the early period.The demographic findings of the patients, laboratory examinations, difficulty of common bile duct (CBD) stones, clinical manifestation of cholangitis, anatomical and pathological conditions of the patients, factors that complicated the ERCP procedure, and consequently the effect of these factors on post-ERCP complications were investigated in both groups.Results: According to the results of this study, the diameter of the CBD and the number of stones increased in elderly patients.On the other hand, the presence of stenosis, enclaved stones in the CBD, and accompanying pancreatitis increased the need for repeated ERCP in young patients.In the prediction of single and repeated ERCP using the univariate model, a significant association (p<0.05) was observed between post-ERCP complications and age, white blood cell count, aspartate aminotransferase (AST), alanine aminotransferase, total bilirubin, direct bilirubin, width, angulation, and shape of the CBD, fever and chills, biliary pancreatitis, cholangitis, and difficult stones.In the prediction of single and repeated ERCP using the multivariate model, a significant association (p<0.05) was observed between post-ERCP complications and AST, fever and chills, biliary pancreatitis, and difficult stones.Conclusion: The need for stenting was higher in both age groups when cholangitis was present.The success rate of ERCP was not affected by a single factor, but by all clinical and pathological factors that increase the difficulty of the procedure.
Authors: Murat Akaydın, Okan Demiray
Institution: Sağlık Bilimleri Üniversitesi
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3196441069