Outcomes and timing of endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis
Copyright © 2019. Published by Elsevier Ltd..
BACKGROUND: Indication of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) is challenging.
AIMS: In this retrospective study, we analyzed real-world data to understand the ERCP practice in ABP in Hungarian centers.
METHODS: Clinical data on ABP patients (2013-2015) were extracted from our large multicentric database. Outcomes, quality indicators and the role of early timing of ERCP (<24 h from admission) were analyzed.
RESULTS: There were 356 patients with ABP. ERCP was performed in 267 (75%). Performance indicators of ERCP proved to be suboptimal with a biliary cannulation rate of 84%. Successful vs unsuccessful cannulation of naïve papilla resulted in lower rates of local [22.9% vs 40.9%, (P = 0.012)] and systemic [4.9% vs 13.6%, (P = 0.042)] complications. Successful vs unsuccessful clearance resulted in lower rates of local complications [22.5% vs 40.8%, (P = 0.008)]. Successful cannulation and drainage correlated with less severe course of ABP [3.6% vs 15.9%, (P = 0.001) and 4.1% vs 12.2%, (P = 0.033)] respectively. A tendency of an increased rate of local complications was observed if ERCP was performed later [<24 h: 21.1% (35/166); between 24-48 h: 23.4% (11/47); >48h: 37.2% (16/43) (P = 0.088)].
CONCLUSION: Optimization of ERCP indication in ABP patients is critical as suboptimal ERCP practices in ABP without definitive stone detection are associated with poorer clinical outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
|---|---|
| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - 51(2019), 9 vom: 08. Sept., Seite 1281-1286 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Halász, Adrienn [VerfasserIn] |
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| Links: |
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| Themen: |
Cholangiopancreatography |
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| Anmerkungen: |
Date Completed 07.04.2020 Date Revised 08.04.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.dld.2019.03.018 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM296510939 |
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| 100 | 1 | |a Halász, Adrienn |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes and timing of endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis |
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| 500 | |a Date Completed 07.04.2020 | ||
| 500 | |a Date Revised 08.04.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019. Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: Indication of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) is challenging | ||
| 520 | |a AIMS: In this retrospective study, we analyzed real-world data to understand the ERCP practice in ABP in Hungarian centers | ||
| 520 | |a METHODS: Clinical data on ABP patients (2013-2015) were extracted from our large multicentric database. Outcomes, quality indicators and the role of early timing of ERCP (<24 h from admission) were analyzed | ||
| 520 | |a RESULTS: There were 356 patients with ABP. ERCP was performed in 267 (75%). Performance indicators of ERCP proved to be suboptimal with a biliary cannulation rate of 84%. Successful vs unsuccessful cannulation of naïve papilla resulted in lower rates of local [22.9% vs 40.9%, (P = 0.012)] and systemic [4.9% vs 13.6%, (P = 0.042)] complications. Successful vs unsuccessful clearance resulted in lower rates of local complications [22.5% vs 40.8%, (P = 0.008)]. Successful cannulation and drainage correlated with less severe course of ABP [3.6% vs 15.9%, (P = 0.001) and 4.1% vs 12.2%, (P = 0.033)] respectively. A tendency of an increased rate of local complications was observed if ERCP was performed later [<24 h: 21.1% (35/166); between 24-48 h: 23.4% (11/47); >48h: 37.2% (16/43) (P = 0.088)] | ||
| 520 | |a CONCLUSION: Optimization of ERCP indication in ABP patients is critical as suboptimal ERCP practices in ABP without definitive stone detection are associated with poorer clinical outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Cholangiopancreatography | |
| 650 | 4 | |a Cholangitis | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Endoscopic retrograde | |
| 650 | 4 | |a Health care | |
| 650 | 4 | |a Pancreatitis | |
| 650 | 4 | |a Quality indicators | |
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| 700 | 1 | |a Pécsi, Dániel |e verfasserin |4 aut | |
| 700 | 1 | |a Farkas, Nelli |e verfasserin |4 aut | |
| 700 | 1 | |a Izbéki, Ferenc |e verfasserin |4 aut | |
| 700 | 1 | |a Gajdán, László |e verfasserin |4 aut | |
| 700 | 1 | |a Fejes, Roland |e verfasserin |4 aut | |
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| 700 | 1 | |a Takács, Tamás |e verfasserin |4 aut | |
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| 700 | 1 | |a Szentesi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Párniczky, Andrea |e verfasserin |4 aut | |
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