TY - JOUR
T1 - Outcome of endoscopic retrograde cholangiopancreatography in patients with clinically defined decompensated liver cirrhosis
AU - Lee, Jong chan
AU - Kim, Joo Seong
AU - Kim, Hyoung Woo
AU - Cho, In Kuk
AU - Lee, Jongchan
AU - Jang, Eun Sun
AU - Lee, Sang Hyub
AU - Hwang, Jin Hyeok
AU - Kim, Jin Wook
AU - Jeong, Sook Hyang
AU - Kim, Jaihwan
N1 - Publisher Copyright:
© 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd
PY - 2018/10
Y1 - 2018/10
N2 - OBJECTIVE: Decompensated liver cirrhosis (LC) can negatively affect the outcome of endoscopic retrograde cholangiopancreatography (ERCP). We aimed to compare the efficacy and safety of ERCP in patients with clinically defined compensated and decompensated LC. METHODS: In a single tertiary hospital, 146 endoscopic sphincterotomy-naive patients with LC who underwent ERCP between 2005 and 2016 were reviewed. Patients with LC who had experienced variceal bleeding, ascites or hepatic encephalopathy were included in the decompensated LC group. Cannulation, technical and clinical successes, and major post-ERCP adverse events including bleeding, pancreatitis, cholangitis and perforation were compared between the two groups. RESULTS: Patients were divided into compensated and decompensated LC groups. Their baseline characteristics were not different, except for comorbid malignancy (22.3 % vs 38.5%, P = 0.038) and preprocedural transfusion (7.4% vs 36.5%, P < 0.001). The cannulation (97,9% vs 94.2%, P = 0.348) and technical (95.7% vs 88.5%, P = 0.167) success rates were not different. The clinical success rate was lower in the decompensated LC group (95.7% and 78.8%, P = 0.003), mainly due to comorbid hepatobiliary malignancy. Post-ERCP pancreatitis (6.4% vs 30.8%, P = 0.008) and cholangitis (18.1% vs 32.7%, P = 0.046) rates were higher in the decompensated LC group. CONCLUSIONS: Despite lower clinical success rates due to comorbid hepatobiliary malignancy, ERCP in patients with decompensated LC is technically feasible. Because postprocedural cholangitis and pancreatitis are more frequent in patients with decompensated LC, greater procedural precautions are needed in these patients.
AB - OBJECTIVE: Decompensated liver cirrhosis (LC) can negatively affect the outcome of endoscopic retrograde cholangiopancreatography (ERCP). We aimed to compare the efficacy and safety of ERCP in patients with clinically defined compensated and decompensated LC. METHODS: In a single tertiary hospital, 146 endoscopic sphincterotomy-naive patients with LC who underwent ERCP between 2005 and 2016 were reviewed. Patients with LC who had experienced variceal bleeding, ascites or hepatic encephalopathy were included in the decompensated LC group. Cannulation, technical and clinical successes, and major post-ERCP adverse events including bleeding, pancreatitis, cholangitis and perforation were compared between the two groups. RESULTS: Patients were divided into compensated and decompensated LC groups. Their baseline characteristics were not different, except for comorbid malignancy (22.3 % vs 38.5%, P = 0.038) and preprocedural transfusion (7.4% vs 36.5%, P < 0.001). The cannulation (97,9% vs 94.2%, P = 0.348) and technical (95.7% vs 88.5%, P = 0.167) success rates were not different. The clinical success rate was lower in the decompensated LC group (95.7% and 78.8%, P = 0.003), mainly due to comorbid hepatobiliary malignancy. Post-ERCP pancreatitis (6.4% vs 30.8%, P = 0.008) and cholangitis (18.1% vs 32.7%, P = 0.046) rates were higher in the decompensated LC group. CONCLUSIONS: Despite lower clinical success rates due to comorbid hepatobiliary malignancy, ERCP in patients with decompensated LC is technically feasible. Because postprocedural cholangitis and pancreatitis are more frequent in patients with decompensated LC, greater procedural precautions are needed in these patients.
KW - decompensation
KW - endoscopic retrograde cholangiopancreatography
KW - liver cirrhosis
KW - postprocedural adverse event
KW - success rate
UR - http://www.scopus.com/inward/record.url?scp=85053708825&partnerID=8YFLogxK
U2 - 10.1111/1751-2980.12661
DO - 10.1111/1751-2980.12661
M3 - Article
C2 - 30126061
AN - SCOPUS:85053708825
SN - 1751-2972
VL - 19
SP - 605
EP - 613
JO - Journal of Digestive Diseases
JF - Journal of Digestive Diseases
IS - 10
ER -