Adrienn Halász1, Dániel Pécsi2, Nelli Farkas3, Ferenc Izbéki4, László Gajdán5, Roland Fejes6, József Hamvas7, Tamás Takács8, Zoltán Szepes9, László Czakó10, Áron Vincze11, Szilárd Gódi12, Andrea Szentesi13, Andrea Párniczky14, Dóra Illés15, Balázs Kui16, Péter Varjú17, Katalin Márta18, Márta Varga19, János Novák20, Attila Szepes21, Barnabás Bod22, Miklós Ihász23, Péter Hegyi24, István Hritz25, Bálint Erőss26. 1. Szent György Teaching Hospital of Fejér County, Székesfehérvár, Hungary. Electronic address: ahalasz@mail.fmkorhaz.hu. 2. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: daniel.pecsi1991@gmail.com. 3. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Bioanalysis and Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: nelli.farkas@aok.pte.hu. 4. Szent György Teaching Hospital of Fejér County, Székesfehérvár, Hungary. Electronic address: fizbeki@gmail.com. 5. Szent György Teaching Hospital of Fejér County, Székesfehérvár, Hungary. Electronic address: lgajdan@yahoo.com. 6. Szent György Teaching Hospital of Fejér County, Székesfehérvár, Hungary. Electronic address: rolldoc@vipmail.hu. 7. Bajcsy-Zsilinszky Teaching Hospital of Semmelweis University, Budapest, Hungary. Electronic address: hamvas.jozsef@bajcsy.hu. 8. First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: takacs.tamas@med.u-szeged.hu. 9. First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: szepes.zoltan@med.u-szeged.hu. 10. First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: czako.laszlo@med.u-szeged.hu. 11. First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: vincze.aron@pte.hu. 12. First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: godi.szilard@pte.hu. 13. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: szentesiai@gmail.com. 14. Heim Pál National Institute for Pediatrics, Budapest, Hungary. Electronic address: andrea.parniczky@gmail.com. 15. First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: illes.dora@med.u-szeged.hu. 16. First Department of Medicine, University of Szeged, Szeged, Hungary. Electronic address: k.kubali@gmail.com. 17. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: varjupet@gmail.com. 18. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: katalin.martak@gmail.com. 19. BMKK, Dr. Réthy Pál Hospital, Békéscsaba, Hungary. Electronic address: drvargamarta@gmail.com. 20. BMKK, Pándy Kálmán Hospital, Gyula, Hungary. Electronic address: drnovakjanos@gmail.com. 21. Bács-Kiskun County University Teaching Hospital, Kecskemét, Hungary. Electronic address: szepesaz@gmail.com. 22. Dr. Bugyi István Hospital of Csongrád County, Szentes, Hungary. Electronic address: bancikab@freemail.hu. 23. Markusovszky Teaching Hospital, Szombathely, Szombathely, Hungary. Electronic address: ihasz.miklos@gmail.com. 24. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, University of Pécs, Pécs, Hungary; MTA-SZTE Momentum Translational Gastroenterology Research Group, Szeged, Hungary. Electronic address: hegyi2009@gmail.com. 25. First Department of Surgery, Center for Therapeutic Endoscopy, Semmelweis University, Budapest, Hungary. Electronic address: istvan.hritz@freemail.hu. 26. Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. Electronic address: eross.balint@pte.hu.
Abstract
BACKGROUND: Indication of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) is challenging. AIMS: In this retrospective study, we analyzed real-world data to understand the ERCP practice in ABP in Hungarian centers. METHODS: Clinical data on ABP patients (2013-2015) were extracted from our large multicentric database. Outcomes, quality indicators and the role of early timing of ERCP (<24 h from admission) were analyzed. RESULTS: There were 356 patients with ABP. ERCP was performed in 267 (75%). Performance indicators of ERCP proved to be suboptimal with a biliary cannulation rate of 84%. Successful vs unsuccessful cannulation of naïve papilla resulted in lower rates of local [22.9% vs 40.9%, (P = 0.012)] and systemic [4.9% vs 13.6%, (P = 0.042)] complications. Successful vs unsuccessful clearance resulted in lower rates of local complications [22.5% vs 40.8%, (P = 0.008)]. Successful cannulation and drainage correlated with less severe course of ABP [3.6% vs 15.9%, (P = 0.001) and 4.1% vs 12.2%, (P = 0.033)] respectively. A tendency of an increased rate of local complications was observed if ERCP was performed later [<24 h: 21.1% (35/166); between 24-48 h: 23.4% (11/47); >48h: 37.2% (16/43) (P = 0.088)]. CONCLUSION: Optimization of ERCP indication in ABP patients is critical as suboptimal ERCP practices in ABP without definitive stone detection are associated with poorer clinical outcomes.
BACKGROUND: Indication of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis (ABP) is challenging. AIMS: In this retrospective study, we analyzed real-world data to understand the ERCP practice in ABP in Hungarian centers. METHODS: Clinical data on ABP patients (2013-2015) were extracted from our large multicentric database. Outcomes, quality indicators and the role of early timing of ERCP (<24 h from admission) were analyzed. RESULTS: There were 356 patients with ABP. ERCP was performed in 267 (75%). Performance indicators of ERCP proved to be suboptimal with a biliary cannulation rate of 84%. Successful vs unsuccessful cannulation of naïve papilla resulted in lower rates of local [22.9% vs 40.9%, (P = 0.012)] and systemic [4.9% vs 13.6%, (P = 0.042)] complications. Successful vs unsuccessful clearance resulted in lower rates of local complications [22.5% vs 40.8%, (P = 0.008)]. Successful cannulation and drainage correlated with less severe course of ABP [3.6% vs 15.9%, (P = 0.001) and 4.1% vs 12.2%, (P = 0.033)] respectively. A tendency of an increased rate of local complications was observed if ERCP was performed later [<24 h: 21.1% (35/166); between 24-48 h: 23.4% (11/47); >48h: 37.2% (16/43) (P = 0.088)]. CONCLUSION: Optimization of ERCP indication in ABP patients is critical as suboptimal ERCP practices in ABP without definitive stone detection are associated with poorer clinical outcomes.
Authors: Dezső Kelemen; Péter Hegyi; Levente Pál Kucserik; Katalin Márta; Áron Vincze; György Lázár; László Czakó; Zsolt Szentkereszty; Mária Papp; Károly Palatka; Ferenc Izbéki; Áron Altorjay; Imola Török; Sorin Barbu; Marcel Tantau; András Vereczkei; Lajos Bogár; Márton Dénes; Imola Németh; Andrea Szentesi; Noémi Zádori; Judit Antal; Markus M Lerch; John Neoptolemos; Miklós Sahin-Tóth; Ole H Petersen Journal: BMJ Open Date: 2019-07-09 Impact factor: 2.692
Authors: Klementina Ocskay; Zsófia Vinkó; Dávid Németh; László Szabó; Judit Bajor; Szilárd Gódi; Patrícia Sarlós; László Czakó; Ferenc Izbéki; József Hamvas; Mária Papp; Márta Varga; Imola Török; Artautas Mickevicius; Ville Sallinen; Elena Ramirez Maldonado; Shamil Galeev; Alexandra Mikó; Bálint Erőss; Marcell Imrei; Péter Jenő Hegyi; Nándor Faluhelyi; Orsolya Farkas; Péter Kanizsai; Attila Miseta; Tamás Nagy; Roland Hágendorn; Zsolt Márton; Zsolt Szakács; Andrea Szentesi; Péter Hegyi; Andrea Párniczky Journal: Sci Rep Date: 2021-12-17 Impact factor: 4.379