Retrospective analysis of complications related to endoscopic retrograde cholangio-pancreatography in patients with cirrhosis vs patients without cirrhosis

doi:10.4254/wjh.v13.i4.472

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 13, Issue 4

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (7026)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-1) series, Tables (1-10) series.

Item

Count

PDF

358

WORD

232

HTML

2465

Figures (1-1)

452

Tables (1-10)

941

Sum=4448

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

681

Download

1893

Sum=2574

Apr 27, 2021 (publication date) through Mar 1, 2026

Times Cited of This Article

Times Cited (5)

Journal Information of This Article

Publication Name

World Journal of Hepatology

ISSN

1948-5182

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Retrospective Study

World J Hepatol. Apr 27, 2021; 13(4): 472-482
Published online Apr 27, 2021. doi: 10.4254/wjh.v13.i4.472

Retrospective analysis of complications related to endoscopic retrograde cholangio-pancreatography in patients with cirrhosis vs patients without cirrhosis

Michelle Bernshteyn, Linda Hu, Umair Masood, Anuj Vikrant Sharma, Danning Huang, Bishnu Sapkota

Michelle Bernshteyn, Linda Hu, Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States

Umair Masood, Anuj Vikrant Sharma, Division of Gastroenterology and Hepatology, State University of New York Upstate Medical University, Syracuse, NY 13210, United States

Danning Huang, Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States

Bishnu Sapkota, Division of Gastroenterology and Hepatology, SUNY Upstate Medical University and Syracuse VA Medical Center, Syracuse, NY 13210, United States

Author contributions: All the authors solely contributed to this paper.

Institutional review board statement: The SUNY Upstate IRB has determined this project is exempt from Institutional Review Board (IRB) review according to federal regulations.

Informed consent statement: Informed consent was not obtained from the participants as this is a retrospective study with no identifying information. Confirmation was obtained from the journal’s technical support.

Conflict-of-interest statement: There are no conflicts of interest with any of the authors.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Michelle Bernshteyn, MD, Doctor, Department of Medicine, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY 13202, United States. bernshtm@upstate.edu

Received: January 26, 2021
Peer-review started: January 26, 2021
First decision: February 13, 2021
Revised: March 8, 2021
Accepted: April 7, 2021
Article in press: April 7, 2021
Published online: April 27, 2021
Processing time: 79 Days and 13.5 Hours

Abstract

BACKGROUND

There is minimal objective data regarding adverse events related to endoscopic retrograde cholangio-pancreatography (ERCP) in patients with cirrhosis compared to those without cirrhosis and even fewer data comparing complications among cirrhosis patients based on severity of cirrhosis.

AIM

To determine if patients with cirrhosis are at increased risk of adverse events related to ERCP: mainly pancreatitis, bleeding, perforation, cholangitis, and mortality; And to see if higher Child-Pugh (CP) score and Model for End-Stage Liver Disease (MELD) score are associated with higher post-ERCP complications.

METHODS

We performed a retrospective analysis of 692 patients who underwent ERCP and analyzed the impact of cirrhosis etiology, gender, type of sedation used during procedure, interventions performed, and co-morbidities on the rate of complications in cirrhosis patients as compared to non-cirrhosis patients.

RESULTS

Overall complications were higher in those with cirrhosis as compared to those without cirrhosis (P = 0.015 at significance level of 0.05). CP class, especially CP class C, was shown to be associated with a significantly higher rate of ERCP complications as compared to CP class A and CP class B (P = 0.010 at significance level of 0.05).

CONCLUSION

The results of our study reaffirm that liver cirrhosis has an impact on the occurrence of complications during ERCP. Our study shows that CP class seems to be more reliable as compared to MELD score in predicting complications of ERCP in cirrhosis patients.

Keywords: Cirrhosis; Complications; Advanced endoscopy; Endoscopic retrograde cholangio-pancreatography

Core Tip: What is previously known is that endoscopic retrograde cholangio-pancreatography is associated with a risk of adverse events. What is new in this manuscript is that complications are increased in patients with cirrhosis as compared to patients without cirrhosis. Statistical significance was demonstrated in patients classified as Child-Pugh (CP) Class C as compared to CP Classes A and B.