Endoscopy 2020; 52(S 01): S149
DOI: 10.1055/s-0040-1704458
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 11:30 – 12:00 ERCP: Challenging access ePoster Podium 5
© Georg Thieme Verlag KG Stuttgart · New York

ERCP IS MORE CHALLENGING IN CASES OF ACUTE BILIARY PANCREATITIS THAN IN ACUTE CHOLANGITIS - A COHORT ANALYSIS OF THE HUNGARIAN ERCP REGISTRY DATA

D Pécsi
1   Medical School, University of Pécs, Insitute for Translational Medicine, Pécs, Hungary
,
S Gódi
2   Medical School, University of Pécs, First Department of Medicine, Pécs, Hungary
,
P Hegyi
1   Medical School, University of Pécs, Insitute for Translational Medicine, Pécs, Hungary
,
L Hanák
1   Medical School, University of Pécs, Insitute for Translational Medicine, Pécs, Hungary
,
I Altorjay
3   University of Debrecen, Second Department of Medicine, Debrecen, Hungary
,
T Bakucz
4   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
L Czakó
5   University of Szeged, First Department of Medicine, Szeged, Hungary
,
G Kovács
3   University of Debrecen, Second Department of Medicine, Debrecen, Hungary
,
Á Orbán-Szilágyi
4   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
F Pakodi
2   Medical School, University of Pécs, First Department of Medicine, Pécs, Hungary
,
Á Patai
6   Markusovszky University Teaching Hospital, Department of Gastroenterology and Medicine, Szombathely, Hungary
,
Z Szepes
5   University of Szeged, First Department of Medicine, Szeged, Hungary
,
T Gyökeres
4   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
R Fejes
7   Szent György University Teaching Hospital of County Fejér, First Department of Medicine, Székesfehérvár, Hungary
,
Z Dubravcsik
8   Bács-Kiskun County University Teaching Hospital, First Department of Medicine, Kecskemét, Hungary
,
Á Vincze
2   Medical School, University of Pécs, First Department of Medicine, Pécs, Hungary
,
Hungarian Endoscopy Study Group › Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Endoscopic retrograde cholangiopancreatography (ERCP) is recommended in acute biliary pancreatitis (ABP) when cholangitis or common bile duct obstruction is present. The inflammation of the pancreas and the surrounding tissues might make the procedure more difficult, however this topic is not widely studied. We compared the outcomes and difficulty of ERCP in ABP and in acute cholangitis (AC) in prospectively collected data of 7 Hungarian tertiary centers.

Methods 240 ABP cases and 250 AC cases without ABP were included. Previous papillotomy, altered gastroduodenal anatomy, and cases with biliary stricture were excluded. The rate of biliary access, advanced cannulation method, adverse events, cannulation and fluoroscopy time, as well as subjective difficulty were evaluated.

Results No difference was found between biliary cannulation rates in the two groups (95.8% vs. 97.2%). Significantly more pancreatic guidewire manipulation (31.3% vs. 17.2%; p< 0.001) and prophylactic pancreatic stent use (19.6% vs. 4.8%; p< 0.001) were seen in the ABP than in AC group. Moreover, longer cannulation time in the ABP patients (248 vs. 185 s; p=0.043) and higher fluoroscopy times (91 vs. 107 s) in the AC group were measured. There was no difference between the rate of adverse events of the groups. No significant difference was found in subjective difficulty.

Conclusions ERCP in ABP cases is more challenging than in AC but does not affect the outcomes in our registry data. The higher frequency of difficult biliary cannulation in the ABP patients warrants the involvement of an experienced endoscopist.