TY - JOUR
T1 - Endoscopic retrograde cholangiopancreatography complications in the era of cholangioscopy
T2 - Is there an increased risk?
AU - Hammerle, Christopher W.
AU - Haider, Shahzad
AU - Chung, Matthew
AU - Pandey, Ambarish
AU - Smith, Ioana
AU - Kahaleh, Michel
AU - Sauer, Bryan G.
N1 - Funding Information:
No grants were used to support this study. The lead author ‘Michel Kahaleh’ has received research grant from Boston Scientific, Emcision, Fuji, Pentax (for ‘biliary endoscopy’), and from Mauna Kea and Mi Tech (for ‘endoscopy’) and works as a consultant for Boston Scientific, Xlumena and Pinnacle.
PY - 2012/9
Y1 - 2012/9
N2 - Background: Single-operator cholangioscopy allows direct visualization of the biliary tree and is being used in the diagnosis and treatment of various biliary conditions. To date, there are few data examining complications of single-operator cholangioscopy. Methods: We evaluated all endoscopic retrograde cholangiopancreatography procedures over a two-year period and compared its complication rate to single-operator cholangioscopy in a tertiary care centre with extensive experience in single-operator cholangioscopy.A total of 2087 patients (55% men, mean age 57.4 ± 16.4) had a therapeutic endoscopic retrograde cholangiopancreatography, out of which 169 also had single-operator cholangioscopy performed on them. Results: 169 single-operator cholangioscopy procedures were performed (53% men) with a mean patient age of 60.7 ± 15.2 years. Out of the 2087 patients, 160 complications occurred (7.7%), and included pancreatitis (n=47, 2.2%), infection (n=24, 1.1%), bleeding (n=44, 2.1%), perforation (n=16, 0.8%) and other (n=29, 1.4%). Univariate analysis on overall complications identified seven variables with a p value < 0.2, which were included in the multivariate analysis. Biliary sphincterotomy, pancreatic duct stent placement, and ampullectomy were associated with increased complications. Single-operator cholangioscopy was not associated with increased complications on multivariate analysis. Conclusion: Single-operator cholangioscopy is not associated with an increased rate of complications when compared to endoscopic retrograde cholangiopancreatography. The types and frequencies of overall endoscopic retrograde cholangiopancreatography complications are similar to previously reported series.
AB - Background: Single-operator cholangioscopy allows direct visualization of the biliary tree and is being used in the diagnosis and treatment of various biliary conditions. To date, there are few data examining complications of single-operator cholangioscopy. Methods: We evaluated all endoscopic retrograde cholangiopancreatography procedures over a two-year period and compared its complication rate to single-operator cholangioscopy in a tertiary care centre with extensive experience in single-operator cholangioscopy.A total of 2087 patients (55% men, mean age 57.4 ± 16.4) had a therapeutic endoscopic retrograde cholangiopancreatography, out of which 169 also had single-operator cholangioscopy performed on them. Results: 169 single-operator cholangioscopy procedures were performed (53% men) with a mean patient age of 60.7 ± 15.2 years. Out of the 2087 patients, 160 complications occurred (7.7%), and included pancreatitis (n=47, 2.2%), infection (n=24, 1.1%), bleeding (n=44, 2.1%), perforation (n=16, 0.8%) and other (n=29, 1.4%). Univariate analysis on overall complications identified seven variables with a p value < 0.2, which were included in the multivariate analysis. Biliary sphincterotomy, pancreatic duct stent placement, and ampullectomy were associated with increased complications. Single-operator cholangioscopy was not associated with increased complications on multivariate analysis. Conclusion: Single-operator cholangioscopy is not associated with an increased rate of complications when compared to endoscopic retrograde cholangiopancreatography. The types and frequencies of overall endoscopic retrograde cholangiopancreatography complications are similar to previously reported series.
KW - Complications
KW - Direct visualization
KW - ERCP
KW - SPY
KW - Single operator cholangioscopy
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U2 - 10.1016/j.dld.2012.04.024
DO - 10.1016/j.dld.2012.04.024
M3 - Article
C2 - 22727634
AN - SCOPUS:84864397168
SN - 1590-8658
VL - 44
SP - 754
EP - 758
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 9
ER -