Risk factors for ERCP-related complications: a review of 1 951 cases

Abstract

Objective To investigate the risk factors for post-ERCP complications. Methods Data of the patients who underwent ERCP in the First Affiliated Hospital of Nanchang University from 1 January 2011 to 31 December 2013 were retrospectively analyzed. Post-ERCP complications were analyzed by univariate and multivariate analyses. Results A total of 277 patients out of 1 951 developed complications, 101(5.18%) pancreatitis, 54(2.77%) hyperamylasemia (not including pancreatitis), 134(6.87%) biliary infection, 8 (0.41%) hemorrhage, 1 (0.05%) obstruction and 1 (0.05%) perforation. Multivariate analyses showed cholangiocarcinoma (P=0.002, OR=2.39, 95%CI: 1.38-4.14), long operation time(>60 min) (P=0.020, OR=3.77, 95%CI: 1.23-11.53) and endoscopic sphincterotomy (EST)(P=0.008, OR=2.56, 95%CI: 1.28-5.14) and entrance of guidewire to pancreatic duct (P=0.012, OR=1.43, 95%CI: 1.08-1.87) were independent risk factors for PEP. Cholangiocarcinoma(P<0.01, OR=2.93, 95%CI: 1.88-4.56), multiple times of ERCP during the period of hospitalization(P<0.01, OR=2.53, 95%CI: 1.63-3.93) were independent risk factors for post-cholangitis. However, EST (P=0.03, OR=0.65, 95%CI: 0.44-0.97) and antibiotics prophylaxis after ERCP (P=0.03, OR=0.64, 95%CI: 0.39-0.95) were protective factors for post-cholangitis. Conclusion Cholangiocarcinoma, endoscopic sphincterotomy, long operation time(>60 min) and entrance of guidewire to pancreatic duct were independent risk factors for PEP. Cholangiocarcinoma and multiple ERCP during the period of hospitalization are independent risk factors for post-cholangitis. EST and antibiotics prophylaxis after ERCP might reduce the occurrence of cholangitis. Key words: Endoscopic retrograde cholangiopancreatography; Post-ERCP pancreatitis; Biliary infection; Risk factors