Outcomes of endoscopic retrograde cholangiopancreatography: a series from a provincial New Zealand hospital

Richards, Simon; Kyle, Stephen; White, Campbell; El‐Haddawi, Falah; Farrant, Glenn; Henderson, Nigel; Fancourt, Michael; Gilkison, William

doi:10.1111/ans.13734

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…These findings suggest that the presence of two wires increases the complexity of the procedure, potentially leading to a higher risk of tissue trauma or injury. Therefore, endoscopists should consider the use of alternative cannulation techniques to reduce the risk of complications in patients undergoing ERCP or the use of prophylactic pancreatic duct stenting to mitigate the Table 3 Comparison with international published studies in terms of sample volume, success and complication rates Richards et al 31…”

Section: Procedural Characteristicsmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study

Salama,

Alnajjar,

Owais

et al. 2023

BMJ Open

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ObjectiveTo evaluate the utilisation and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures, success rates, incidence and risk factors for procedural-related complications in a single centre-based study.Study designRetrospective cohort study.SettingFirst advanced tertiary endoscopy centre in Palestine.ParticipantsA total of 1909 procedures on 1303 patients were included in the analysis: females were 57.9% of the cases (n=755), 1225 patients (94%) were from West Bank and Jerusalem and 78 (6%) were from Gaza Strip. All patients who underwent ERCP throughout the period from December 2017 to September 2022 were selected to participate in the study.Primary and secondary outcome measuresThe primary outcomes of interest in our analysis were success rates, procedural outcomes and post- procedural complications including pancreatitis, bleeding and others. Two multivariate logistic regression models were performed to calculate the risk of post-ERCP complications and post-ERCP pancreatitis (PEP) in patients with certain risk factors like demographic factors, procedural techniques' variation, pancreatic duct manipulations and others. We also discussed the management of the failed procedures.ResultsThe overall complication rate was 5%, including PEP (n=43, 2.3%), infection/cholangitis (n=20, 1%), bleeding (n=9, 0.5%) and perforation (n=7, 0.4%). The mortality rate was 0.6% (n=11). Risk factors for adverse events included pancreatic duct cannulation and PEP (p<0.001, OR=3.64). Additionally, younger patients (≤45) were found to carry a higher risk for PEP when compared with older patients (≥65) (p=0.023, OR=2.84). In comparison with sphincterotomy, the double-wire technique was associated with a higher risk of complications (p=0.033, OR=2.29).ConclusionsWe summarised the utilisation and outcomes of ERCP among the Palestinian population in the first advanced centre in Palestine. Cannulation success rates are similar to the established standards and are acceptable compared with other centres worldwide. Perioperative complication rates of ERCP remain infrequent, and death is quite unusual and thus considered a safe procedure.

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Section: Procedural Characteristicsmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study

Salama,

Alnajjar,

Owais

et al. 2023

BMJ Open

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“…All the patients received a local anaesthetic Lidocaine throat spray with either balanced Mida-zolam and Propofol based sedation or general anaesthesia, 11 led by an anaesthetist depending on patient factors. Blood pressure, pulse, oxygen satura-tion, ECG tracing and level of sedation was noted every five minutes, 12 by either a trained endoscopy nurse or a resident gastroenterologist.…”

Section: Introductionmentioning

confidence: 99%

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

Kazmi

Khan

Alam

et al. 2022

PAFMJ

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Objective: To determine the demographics, indications and frequency of interventions and complications endoscopic retrograde cholangiopancreatography (ERCP). Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: The study included all the elective and emergency ERCP procedures from January 2019 to December 2019. Results: Out of 1030 patients who underwent endoscopic retrograde cholangio-pancreaticography, 903 were enrolled. Sixtyone percent of the participants were males. The mean age was 56 ± 16 years, with the majority of the patients lying in the age range of 41-65 years. The most common indication for ERCP in this study was choledocholithiasis (47%), the most common complication encountered was acute pancreatitis (2.1%), and a mortality rate of 0.2% was reported. The complication rate was statistically related to the intervention rather than the age and gender of the patients. Conclusion: The most common indication for ERCP remains choledocholithiasis, with the most common ERCP complication being acute pancreatitis followed by stent migration. Biliary fistulae, post-surgical biliary leaks and strictures, pancreatic pseudo cysts, acute cholangitis, choledocholithiasis and cholestasis secondary to as cariasis were found in a relatively younger group. The success rate was above 95% for high volume centres.

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Cholecystectomy With Intraoperative Endoscopic Retrograde Cholangiopancreatography: Does the Order Matter?

Castelan Filho,

Zapelini,

Cacciatori

et al. 2024

ABCD, arq. bras. cir. dig.

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BACKGROUND: The recommended treatment for cholecystocholedocholithiasis is cholecystectomy (CCT) associated with endoscopic retrograde cholangiopancreatography (ERCP). CCT with intraoperative ERCP is associated with higher success rates and lower hospital stays and hospital costs. However, some case series do not describe the exact methodology used: whether ERCP or CCT was performed first. AIMS: Verify if there is a difference, in terms of outcomes and complications, when intraoperative ERCP is performed immediately before or after CCT. METHODS: This is a retrospective case-control study analyzing all patients who underwent CCT with intraoperative ERCP between January 2021 and June 2022, in a tertiary hospital in southern Brazil, for the treatment of cholecystocholedocholithiasis. RESULTS: Out of 37 patients analyzed, 16 (43.2%) underwent ERCP first, immediately followed by CCT. The overall success rate for the cannulation of the bile duct was 91.9%, and bile duct clearance was achieved in 75.7% of cases. The post-ERCP pancreatitis rate was 10.8%. When comparing the "ERCP First" and "CCT First" groups, there was no difference in technical difficulty for performing CCT. The "CCT First" group had a higher rate of success in bile duct cannulation (p=0.020, p<0.05). Younger ages, presence of stones in the distal common bile duct and shorter duration of the procedure were factors statistically associated with the success of the bile duct clearance. Lymphopenia and cholecystitis as an initial presentation, in turn, were associated with failure to clear the bile duct. CONCLUSIONS: There was no significant difference in terms of complications and success in clearing the bile ducts among patients undergoing CCT and ERCP in the same surgical/anesthetic procedure, regardless of which procedure was performed first. Lymphopenia and cholecystitis have been associated with failure to clear the bile duct.

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Outcomes of endoscopic retrograde cholangiopancreatography: a series from a provincial New Zealand hospital

Abstract: ERCP can be safely and successfully performed in a provincial centre.

Cited by 3 publications

References 19 publications

Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study

Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study

A Year of Endoscopic Retrograde Cholangiopancreatography (ERCP) At a Glance. Indications, Interventions, Complications

Cholecystectomy With Intraoperative Endoscopic Retrograde Cholangiopancreatography: Does the Order Matter?

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