PREDICTIVE FACTORS FOR THERAPEUTIC ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY-RELATED COMPLICATIONS IN THE TREATMENT OF CHOLEDOCHOLITHIASIS

Aims Endoscopic retrograde cholangiopancreatography (ERCP) is now the exclusive endoscopic therapeutic modality for biliary as well as pancreatic diseases.

The aim of our study is to evaluate the complication rate of ERCP in the treatment of choledocholithiasis and to assess the factors related to their occurrence.

Methods This is a retrospective descriptive and analytical study including 1048 patients who underwent ERCP for choledocholithiasis between January 2007 and August 2021.

The factors associated with the occurrence of post-ERCP complications were studied by logistic regression analysis.

Results Among the patients studied, 60.5% had a solitary stone, 27.6% had multiple choledochal stones and 11.9% had large stones (>15mm).

Clinically, 18.7% of the patients presented with cholangitis and 9.4% with acute pancreatitis.

A periampullary diverticulum was found in 9.4% of cases.

A common bile duct stenosis was present in 6.5% of patients.

The primary vacuity rate after ERCP was 77.3%. However, additional maneuvers were used in 20.5% of cases.

Complications were reported in 5.8% of cases , including haemorrhage in 4.5%, pancreatitis in 0.8%, cholangitis in 0.2%, perforation in 0.1% and dormia impaction in 0.2%.No deaths was reported due to our procedures.

In a multivariate analysis following adjustment of confounding factors, only the presence of a large stone (OR=5.9, CI (1.460- 23.875), p=0.013) and female gender (OR=1.867, CI (1.012-3.444), p=0.046) increased the risk of complications during ERCP.

Conclusions Our study suggests that female gender and the presence of a large gallstone are associated with a high risk of post-ERCP complications.

Publication History

Article published online:
14 April 2022