ERCP PERFORMANCE IN A TERTIARY BRAZILIAN CENTER: FOCUS ON NEW RISK FACTORS, COMPLICATIONS AND QUALITY INDICATORS

Overview

Journal Arq Bras Cir Dig

Specialties Gastroenterology
General Surgery

Date 2018 Jun 28

PMID 29947682

Citations 3

Authors

Alana Costa Borges

Paulo Cesar de Almeida

Stella Maria Torres Furlani

Marcelo de Sousa Cury

Douglas K Pleskow

Affiliations

Soon will be listed here.

Abstract

Background: ERCP can lead to complications, which can be prevented by the recognition of risk factors.

Aim: To identify these risk factors, with quality evaluation.

Methods: Retrospective study in a Brazilian hospital in 194 patients, excluding surgically altered anatomy.

Results: 211 ERCPs were performed: 97.6% were therapeutic, 83.4% were started by trainees, with deep cannulation rate of 89.6%. Precut was needed in 16.6% of the ERCPs and classic sphincterotomy in 67.3%, with 75.4% of ductal clearance at single session and 8.0% of technical failure. Inacessible papillas ocurred in 2.5% of cases. There were 2.5% of late complications and 16% of early complications. Multivariate analysis identified six predictors for early complications: fistulotomy precut (OR=3.4, p=0.010), difficult cannulation (OR=21.5, p=0.002), attending's procedural time (OR=2.4, p=0.020), choledocholithiasis (adjusted OR=1.8, p=0.015), cannulation time (adjusted OR=3.2, p=0.018) and ERCP duration (adjusted OR=2.7, p=0.041).

Conclusion: Six risk factors for post-ERCP complications were identified. ERCP duration and cannulation time are suggested as new potential quality indicators.

Citing Articles

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