Analysis of risk factors of the severity of post-ERCP hemorrhage in the patients with choledocholithiasis

Abstract

Objective To study the risk factors related to the severity of post-ERCP hemorrhage in the patients with choledocholithiasis. Methods Clinical data of 56 patients with choledocholithiasis and post-ERCP hemorrhage from January 2008 to August 2015 were analyzed.Made the occurrence of severe hemorrhage as dependent variable, supposed 18 factors in patients and procedure related aspects as possible covariates, analyzed with univariate and binary logistic regression. Results Severe hemorrhage was occurred in 11 patients after ERCP.Among patients related factors, female, history of oral corticosteriod, level of bilirubin, size of stone, periampullary diverticula, prolonged time of bleeding-cruor, acute cholangitis, acute pancreatitis and course of disease were proved to be significant risk factors by univariate analysis(P<0.01). Periampullary diverticula, prolonged time of bleeding-cruor and acute cholangitis were independent risk factors in further multivariate analysis(P=0.023, 0.036, 0.045). Among procedure related factors, EPBD(P<0.01), EST(P<0.01), residual biliary stones(P=0.029) were proved to be significant risk factors by univariate analysis, and EPBD was found as independent risk factor(P=0.029) by multivariate analysis. Conclusion Appearance of periampullary diverticula, prolonged time of bleeding-cruor and acute cholangitis were considered as risk factors related to severity of post-ERCP hemorrhage in patients with choledocholithiasis.Moreover, EPBD was also an independent risk factor which might aggravate severity of post-ERCP hemorrhage. Key words: Cholangiopancreatography, endoscopic retrograde; Choledocholithiasis; Hemorrhage; Risk factors