Female gender and post-ERCP pancreatitis: Is the association caused by difficult cannulation?

Vihervaara, Hanna; Hurme, Saija; Gullichsen, Risto; Laine, Seppo; Grönroos, Juha

doi:10.3109/00365521.2011.619275

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…No Reino Unido, a taxa de canulação do ducto ocorre em torno de 84%, portanto, discretamente abaixo de outros centros, desfecho este que provavelmente está relacionado ao fato do país realizar o procedimento em centros de baixo volume resultando em menor experiência com o procedimento 19 . As diretrizes do Joint Advisory Group (JAG), publicadas em 2009, que promovem auditoria frequente de qualidade e segurança de cada modalidade de endoscopia, orientam que a conclusão do procedimento terapêutico pretendido deve ser alcançada em pelo menos 80% dos casos, estando, assim, os valores encontrados nesse estudo dentro do recomendado 20 .…”

Section: Resultsunclassified

Colangiopancreatografia endoscópica retrógrada: análise do perfil epidemiológico e complicações

Da Costa,

Alécio,

De Campos

et al. 2023

Braz. J. Hea. Rev.

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A colangiopancreatografia retrógrada endoscópica (CPRE) é uma importante ferramenta diagnóstica e terapêutica empregada na abordagem de doenças hepatobiliares e pancreáticas. A pancreatite pós-CPRE é a complicação mais comum desse procedimento. Avaliamos os resultados dos procedimentos de pacientes submetidos à CPRE em um serviço de referência do SUS, determinando a taxa de sucesso, perfil epidemiológico e frequência de complicações. Estudo retrospectivo e transversal realizado no período de Agosto de 2019 a Dezembro de 2020, com amostra final de 217 pacientes. As informações foram colhidas do banco de dados do serviço de Endoscopia da Santa Casa de Maceió, foi utilizado questionário semiestruturado, contendo idade, sexo e dados referentes a CPRE: indicação do procedimento, taxa de sucesso, além das complicações. A descrição dos dados obtidos foi apresentada por meio de estatística descritiva. Observamos predomínio do sexo feminino (70,5%), com média de idade 53,9 anos. Todos os procedimentos foram terapêuticos e a coledocolitíase representou a principal indicação (76,4%). Os procedimentos mais realizados foram: canulação biliar para retirada de cálculo (62,2%), passagem de endoprótese biliar (19,8%) e retirada de prótese biliar (10,5%). A taxa de sucesso do procedimento foi de 92,6%, as complicações ocorreram em 6,45%, sendo a principal delas a pancreatite aguda em 3,7%. O estudo demonstrou que a principal indicação para a realização da CPRE foi desobstrução biliar por cálculo. A taxa de sucesso observada do procedimento foi 92,6%. As complicações após CPRE foram pouco frequentes (6,45%), sendo a de maior frequência a pancreatite aguda, com incidência de 3,7%.

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Section: Resultsunclassified

Colangiopancreatografia endoscópica retrógrada: análise do perfil epidemiológico e complicações

Da Costa,

Alécio,

De Campos

et al. 2023

Braz. J. Hea. Rev.

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“…However, overall adverse event rates including post‐ERCP pancreatitis did not differ significantly between groups. In addition, the rate of adverse events occurrence was relatively lower in the current study than in other studies, especially in case of post‐ERCP pancreatitis . The lower adverse event rate would be associated with the clinician's effort to reduce the number of papilla attempts.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, the rate of adverse events occurrence was relatively lower in the current study than in other studies, especially in case of post-ERCP pancreatitis. 8,9 The lower adverse event rate would be associated with the clinician's effort to reduce the number of papilla attempts. In the present study, selective biliary cannulation was achieved within two to four papilla attempts in all patients who achieved primary biliary cannulation.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a novel highly flexible‐tip guidewire on selective biliary cannulation compared to conventional guidewire: Randomized controlled study

Park

Jeong

Lee

2017

Digestive Endoscopy

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“…Female sex has been associated with the development of PEP in those without PSC, although the underlying mechanism remains unclear [ 4 , 37 , 38 ]. Difficult cannulation and increased incidence of the sphincter of Oddi dysfunction have been postulated as possible contributing factors [ 39 ]. In this meta-analysis, female sex was not associated with increased PEP in patients with PSC (OR 1.546, 95% CI 0.882–2.709; p = 0.128; I 2 = 47.6%).…”

Section: Discussionmentioning

confidence: 99%

ERCP-Related Adverse Events in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

Natt

Michael

et al. 2022

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims. While endoscopic retrograde cholangiopancreatography (ERCP) is a valuable diagnostic and therapeutic tool in primary sclerosing cholangitis (PSC), there is conflicting data on associated adverse events. The aims of this systematic review and meta-analysis are to (1) compare ERCP-related adverse events in patients with and without PSC and (2) determine risk factors for ERCP-related adverse events in PSC. Methods. Embase, PubMed, and CENTRAL were searched between January 1, 2000, and May 12, 2021. Eligible studies included adults with PSC undergoing ERCP and reported at least one ERCP-related adverse event (cholangitis, pancreatitis, bleeding, and perforation) or an associated risk factor. The risk of bias was assessed with the Newcastle-Ottawa scale and Cochrane Risk of Bias 2. Raw event rates were used to calculate odds ratios (ORs) and then pooled using random-effects models. Results. Twenty studies met eligibility criteria, of which four were included in a meta-analysis comparing post-ERCP adverse events in patients with PSC (n = 715) to those without PSC (n = 9979). We found a significant threefold increase in the 30-day odds of cholangitis in PSC compared to those without (OR 3.263, 95% CI 1.076–9.896; p = 0.037 ). However, there were no significant differences in post-ERCP pancreatitis (PEP), bleeding, or perforation. Due to limitations in primary data, only risk factors contributing to PEP could be analyzed. Accidental passage of the guidewire into the pancreatic duct (OR 7.444, 95% CI 3.328–16.651; p < 0.001 ; I2 = 65.0%) and biliary sphincterotomy (OR 4.802, 95% CI 1.916–12.033; p = 0.001 ; I2 = 73.1%) were associated with higher odds of PEP in a second meta-analysis including five studies. Conclusions. In the context of limited comparative data and heterogeneity, PSC patients undergoing ERCP have higher odds of cholangitis despite the majority receiving antibiotics. Additionally, accidental wire passage and biliary sphincterotomy increased the odds of PEP. Future studies on ERCP-related risks and preventive strategies are needed.

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Female gender and post-ERCP pancreatitis: Is the association caused by difficult cannulation?

Abstract: The study was not able to confirm that the cannulation of the female papilla is more troublesome than the cannulation of the male papilla.

Cited by 8 publications

References 15 publications

Colangiopancreatografia endoscópica retrógrada: análise do perfil epidemiológico e complicações

Colangiopancreatografia endoscópica retrógrada: análise do perfil epidemiológico e complicações

Effectiveness of a novel highly flexible‐tip guidewire on selective biliary cannulation compared to conventional guidewire: Randomized controlled study

ERCP-Related Adverse Events in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

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