Po-Hsiang Ting1,2, Jiing-Chyuan Luo1,2,3, Kuey-Chung Lee1,2, Tseng-Shing Chen1,2, Yi-Hsiang Huang1,2, Ming-Chih Hou1,2, Fa-Yauh Lee1,2. 1. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 3. Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan, ROC.
Abstract
BACKGROUND: For decades, endoscopic retrograde cholangiopancreatography (ERCP) has been widely performed as a diagnostic and therapeutic procedure for biliary and pancreatic diseases. Complications of ERCP include pancreatitis, hemorrhage, perforation, cholangitis, and cholecystitis. There are few studies that focus on the incidence of post-ERCP cholecystitis and its potential risk factors. METHODS: A retrospective single-center study was performed in 1345 ERCP procedures after excluding patients with current cholecystitis or post-cholecystectomy between January 2009 and December 2011. Potential risk factors for post-ERCP acute cholecystitis, including age, gender, biochemistry, imaging data, procedures such as endoscopic sphincterotomy (EPT), or endoscopic retrograde biliary drainage (ERBD), were obtained and analyzed by multivariate logistic regression analysis. RESULTS: Cholecystitis developed after 13 (0.96%) of the 1345 ERCP procedures. Univariate and multivariate logistic regression analyses showed that cystic duct stones (odds ratio [OR] = 198.26; 95% CI, 5.12-7835.44) and ERBD (OR = 37.58; 95% CI, 3.25-445.56) were important potential risk factors for post-ERCP cholecystitis. The percentage of ERBD procedures and cystic duct stones in patients with post-ERCP cholecystitis was 76.9% and 39.8%, respectively. The 13 patients with post-ERCP cholecystitis all received antibiotics, and four of them also received percutaneous gallbladder drainage. All patients recovered without significant clinical event or mortality. CONCLUSION: The incidence of post-ERCP cholecystitis was 0.96% in the 1345 ERCP procedures performed. Cyst duct stones and ERBD were found to be risk factors for post-ERCP cholecystitis.
BACKGROUND: For decades, endoscopic retrograde cholangiopancreatography (ERCP) has been widely performed as a diagnostic and therapeutic procedure for biliary and pancreatic diseases. Complications of ERCP include pancreatitis, hemorrhage, perforation, cholangitis, and cholecystitis. There are few studies that focus on the incidence of post-ERCP cholecystitis and its potential risk factors. METHODS: A retrospective single-center study was performed in 1345 ERCP procedures after excluding patients with current cholecystitis or post-cholecystectomy between January 2009 and December 2011. Potential risk factors for post-ERCP acute cholecystitis, including age, gender, biochemistry, imaging data, procedures such as endoscopic sphincterotomy (EPT), or endoscopic retrograde biliary drainage (ERBD), were obtained and analyzed by multivariate logistic regression analysis. RESULTS:Cholecystitis developed after 13 (0.96%) of the 1345 ERCP procedures. Univariate and multivariate logistic regression analyses showed that cystic duct stones (odds ratio [OR] = 198.26; 95% CI, 5.12-7835.44) and ERBD (OR = 37.58; 95% CI, 3.25-445.56) were important potential risk factors for post-ERCP cholecystitis. The percentage of ERBD procedures and cystic duct stones in patients with post-ERCP cholecystitis was 76.9% and 39.8%, respectively. The 13 patients with post-ERCP cholecystitis all received antibiotics, and four of them also received percutaneous gallbladder drainage. All patients recovered without significant clinical event or mortality. CONCLUSION: The incidence of post-ERCP cholecystitis was 0.96% in the 1345 ERCP procedures performed. Cyst duct stones and ERBD were found to be risk factors for post-ERCP cholecystitis.