Evaluation of ERCP-related Perforation: a Single-center Retrospective Study

Overview

Journal Gastroenterol Rep (Oxf)

Specialty Gastroenterology

Date 2024 May 20

PMID 38766494

Authors

Feng Zhou

Xiaoyun Zhan

Dan Hu

Nanzhen Wu

Junbo Hong

Guohua Li

Youxiang Chen

Xiaojiang Zhou

Affiliations

Soon will be listed here.

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation is a rare and serious adverse event. The aim of our study was to evaluate the risk factors and management of ERCP-related perforation, and to further determine the predictive factors associated with perforation outcome.

Methods: A total of 27,018 ERCP procedures performed at the First Affiliated Hospital of Nanchang University (Nanchang, China) between January 2007 and March 2022 were included in the investigation of ERCP-related perforation. Medical records and endoscopic data were extracted to analyse the risk factors, management, and clinical outcome of ERCP-related perforation.

Results: Seventy-six patients (0.28%) were identified as having experienced perforation following ERCP. Advanced age, Billroth II anatomy, precut sphincterotomy, and papillary balloon dilatation were significantly associated with ERCP-related perforation. Most patients with perforation (=65) were recognized immediately during ERCP whereas 11 were recognized later on. The delay in recognition primarily resulted from stent migration (=9). In addition, 12 patients experienced poor clinical outcome including death or hospice discharge (=3), ICU admission for >3 days (=6), and prolonged hospital stay for >1 month due to perforation (=3). Cancer and systemic inflammatory response syndrome (SIRS) are associated with a higher risk of poor outcome.

Conclusions: Advanced age, Billroth II anatomy, precut sphincterotomy, and balloon dilation increase the risk of ERCP-related perforation whereas cancer and SIRS independently predicted poor clinical outcome.

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