Xiaoling Ye1, Yu Zhang1, Xinyue Wan1, Tao Deng2. 1. Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China. 2. Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China. dengtao1323@163.com.
Abstract
BACKGROUND/AIMS: Hemorrhage is a serious complication of endoscopic retrograde cholangiopancreatography (ERCP). However, there is a lack of comparative studies on immediate and delayed hemorrhage. The present study aims to explore the relevant risk factors of immediate and delayed hemorrhage of ERCP and compare the similarities and differences. METHODS: ERCP cases conducted by our hospital between January 2017 and January 2020 were selected for retrospective analysis. Then age, gender, basic disease, laboratory examinations, and other relevant clinical information were collected for the analysis. RESULTS: A total of 1009 ERCP cases were included in the present study. Among these cases, 76 patients were in the immediate hemorrhage group, 28 patients were in the delayed hemorrhage group, and 905 patients were in the non-hemorrhage group. The univariate analysis revealed that choledocholithiasis, pre-cut, and endoscopic papillary sphincterotomy (EST) were risk factors for immediate hemorrhage, while cholangitis, jaundice, coronary heart disease, pre-cut, high postoperative lipase at four hours and amylase at 24 h, high postoperative leukocyte, urea, bilirubin, low postoperative platelet counts and fibrinogen, and prolonged prothrombin time (PT) and thrombin time (TT) were risk factors for delayed hemorrhage. The logistic regression analysis revealed that EST, pre-cut, and activated partial thromboplastin time (APTT) were independent risk factors for immediate hemorrhage, while high amylase at 24 h after ERCP, high postoperative urea, prolonged TT, and coronary heart disease were independent risk factors for delayed hemorrhage. CONCLUSIONS: Pre-cut was a common risk factor for immediate and delayed hemorrhage, while other risk factors were different.
BACKGROUND/AIMS: Hemorrhage is a serious complication of endoscopic retrograde cholangiopancreatography (ERCP). However, there is a lack of comparative studies on immediate and delayed hemorrhage. The present study aims to explore the relevant risk factors of immediate and delayed hemorrhage of ERCP and compare the similarities and differences. METHODS: ERCP cases conducted by our hospital between January 2017 and January 2020 were selected for retrospective analysis. Then age, gender, basic disease, laboratory examinations, and other relevant clinical information were collected for the analysis. RESULTS: A total of 1009 ERCP cases were included in the present study. Among these cases, 76 patients were in the immediate hemorrhage group, 28 patients were in the delayed hemorrhage group, and 905 patients were in the non-hemorrhage group. The univariate analysis revealed that choledocholithiasis, pre-cut, and endoscopic papillary sphincterotomy (EST) were risk factors for immediate hemorrhage, while cholangitis, jaundice, coronary heart disease, pre-cut, high postoperative lipase at four hours and amylase at 24 h, high postoperative leukocyte, urea, bilirubin, low postoperative platelet counts and fibrinogen, and prolonged prothrombin time (PT) and thrombin time (TT) were risk factors for delayed hemorrhage. The logistic regression analysis revealed that EST, pre-cut, and activated partial thromboplastin time (APTT) were independent risk factors for immediate hemorrhage, while high amylase at 24 h after ERCP, high postoperative urea, prolonged TT, and coronary heart disease were independent risk factors for delayed hemorrhage. CONCLUSIONS: Pre-cut was a common risk factor for immediate and delayed hemorrhage, while other risk factors were different.
Authors: Mika Ukkonen; Antti Siiki; Anne Antila; Tuula Tyrväinen; Juhani Sand; Johanna Laukkarinen Journal: Dig Dis Sci Date: 2016-08-26 Impact factor: 3.199