Abstract
Background Many epidemiological studies have investigated the risk factors for clonorchiasis, but endoscopic findings of this disease in endoscopic retrograde cholangiopancreatography (ERCP) have not been well characterized. In this study, we evaluated clonorchiasis in ERCP in patients with biliary and pancreatic diseases. Methods This was a retrospective two-center study in hospitalized patients who received ERCP between January 2012 and October 2018. All patients were divided into clonorchiasis and nonclonorchiasis groups. Data were analyzed using univariate analysis and multivariate analyses. Results A total of 1119 patients were included, and clonorchiasis was diagnosed in 19.2% patients. Detection of Clonorchis sinensis eggs in bile samples was higher than that in fecal samples (85.9% vs. 58.7%; P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P = 0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, Conclusions The detection of C. sinensis eggs was significantly higher in bile than in fecal samples; thus, bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. We found that male, age ≤ 60 years old, and CBD diameter < 12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor.C. sinensis eggs was significantly higher in bile than in fecal samples; thus, bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. We found that male, age ≤ 60 years old, and CBD diameter < 12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor.
Highlights
Clonorchiasis, which is caused by Clonorchis sinensis, globally affects more than 15 million people, 13 million of whom live in China and other parts of East Asia [1,2,3]
Multivariate analysis showed that endoscopic diagnosis of clonorchiasis was significantly different between two groups, but it was not an independent risk factor for clonorchiasis. It could be influenced by subjective judgment, resulting in a low sensitivity for direct diagnosis (15/41, 36.6%). Our research suggested both demographic factors of male and age ≤ 60 years old and common bile duct (CBD) diameter < 12 mm as independent risk factors for clonorchiasis, while papilla fistula emerged as protective factor in the analysis
It is established that infection with C. sinensis is one of the most important factors for cholangiocarcinoma [33, 34], but our study found no significant differences in the brush results between clonorchiasis and nonclonorchiasis
Summary
Clonorchiasis, which is caused by Clonorchis sinensis, globally affects more than 15 million people, 13 million of whom live in China and other parts of East Asia [1,2,3]. Common assays for diagnosing clonorchiasis include serologic detection of parasite-specific antibody and DNA [11,12,13,14,15], egg detection in bile and fecal samples [16, 17], and imaging [18]. We evaluated clonorchiasis in ERCP in patients with biliary and pancreatic diseases. Male patients (95% confidence interval (CI): 1.945–4.249, P = 0:0001), age ≤ 60 years old (95% CI: 1.212–2.474, P = 0:003), patients with papilla fistula (95% CI: 0.081–0.900, P = 0:033), and patients with a common bile duct (CBD) diameter < 12 mm (95% CI: 1.093–2.130, P = 0:013) were associated with clonorchiasis incidence. The detection of C. sinensis eggs was significantly higher in bile than in fecal samples; bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. Age ≤ 60 years old, and CBD diameter < 12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor
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