1. Outcomes and timing of endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis.
- Author
-
Halász A, Pécsi D, Farkas N, Izbéki F, Gajdán L, Fejes R, Hamvas J, Takács T, Szepes Z, Czakó L, Vincze Á, Gódi S, Szentesi A, Párniczky A, Illés D, Kui B, Varjú P, Márta K, Varga M, Novák J, Szepes A, Bod B, Ihász M, Hegyi P, Hritz I, and Erőss B
- Subjects
- Adult, Aged, Biliary Tract Diseases complications, Catheterization methods, Female, Gallstones complications, Humans, Length of Stay, Male, Middle Aged, Pancreatitis etiology, Prospective Studies, Retrospective Studies, Severity of Illness Index, Biliary Tract Diseases diagnosis, Cholangiopancreatography, Endoscopic Retrograde methods, Pancreatitis diagnosis
- Abstract
Background: Indication of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) is challenging., Aims: In this retrospective study, we analyzed real-world data to understand the ERCP practice in ABP in Hungarian centers., Methods: Clinical data on ABP patients (2013-2015) were extracted from our large multicentric database. Outcomes, quality indicators and the role of early timing of ERCP (<24 h from admission) were analyzed., Results: There were 356 patients with ABP. ERCP was performed in 267 (75%). Performance indicators of ERCP proved to be suboptimal with a biliary cannulation rate of 84%. Successful vs unsuccessful cannulation of naïve papilla resulted in lower rates of local [22.9% vs 40.9%, (P = 0.012)] and systemic [4.9% vs 13.6%, (P = 0.042)] complications. Successful vs unsuccessful clearance resulted in lower rates of local complications [22.5% vs 40.8%, (P = 0.008)]. Successful cannulation and drainage correlated with less severe course of ABP [3.6% vs 15.9%, (P = 0.001) and 4.1% vs 12.2%, (P = 0.033)] respectively. A tendency of an increased rate of local complications was observed if ERCP was performed later [<24 h: 21.1% (35/166); between 24-48 h: 23.4% (11/47); >48h: 37.2% (16/43) (P = 0.088)]., Conclusion: Optimization of ERCP indication in ABP patients is critical as suboptimal ERCP practices in ABP without definitive stone detection are associated with poorer clinical outcomes., (Copyright © 2019. Published by Elsevier Ltd.)
- Published
- 2019
- Full Text
- View/download PDF