Evaluation of endoscopic retrograde cholangiopancreatography procedures performed in general hospitals in France

Possible mortality reduction by endoscopic sphincterotomy during endoscopic retrograde cholangiopancreatography: a population-based case–control study

“…Findings have shown that ERCP can be conducted safely for very elderly patients (age [90 years) [25]. Nonetheless, other studies have concluded that the main risk factors for death after ERCP are older age and comorbidity [13,26,27], results consistent with our findings.…”

“…Several risk factors for complications have been identified including female sex, young age, sphincter of Oddi dysfunction, difficult cannulation involving a high number of contrast injections or instrumentation in the pancreatic duct, precut sphincterotomy, inexperienced endoscopist, and failure to achieve drainage [6][7][8][9][10]. Post-ERCP mortality, estimated at about 0.5-1% [5,11,12], is considered to arise mainly due to the patient's comorbidity [13] rather than because of procedure-related factors.…”

Prevention of post-ERCP pancreatitis

“…One retrospective study identified taking pancreato-toxic drugs (oestrogen, azathioprine, valproic acid, mesalazine, morphine derivatives and prednisone) increased the occurrence of post-ERCP pancreatitis (OR = 3.7) [12] . Another retrospective study of 506 patients identified angiotensin receptor blockers and smoking as independent risk factors for post-ERCP pancreatitis [13] whereas a recent case-control study of 6505 patients identified smoking and chronic liver disease as factors that reduced the risk of post-ERCP pancreatitis [14] . Testoni et al [7] conducted a large prospective multicentre trial (total of 3635 ERCP procedures) and showed that the rate of post-ERCP pancreatitis did not differ between high-and low-volume centres (3.9% vs 3.1%).…”

“…One French study showed no risk associated with operator inexperience [14] . In the multivariate analysis of a randomised controlled multicentre study by Cheng et al [8] , trainee involvement in the procedure was found to be a risk factor (OR = 1.5) for development of post-ERCP pancreatitis.…”

Efectividad De La Colangiografía Retrógrada Endoscópica en La Resolución De La Coledocolitiasis.

“…Los factores relacionados con el fracaso de CRE incluyen las variaciones anatómicas especialmente las posquirúrgicas, la presencia de divertículos duodenales, los grandes cálculos impactados, los cálculos intrahepáticos y la estenosis de la vía biliar, entre otros. Las complicaciones más frecuentes de la CRE son la pancreatitis aguda, la hemorragia post esfinterotomía, la sepsis de origen biliar y la perforación que aparecen entre un 4 y 16%, y presentan una mortalidad del 0 al 1.5% [13,14]. El objetivo principal de este estudio fue medir el porcentaje de éxito de la Colangiografía retrograda endoscópica en el tratamiento la litiasis de la vía biliar principal.…”