ADVERSE EVENTS RELATED TO ERCP WITH CHOLANGIOSCOPY IN LIVER TRANSPLANT RECIPIENTS
Recommended Citation
Jamali T, Nimri F, Chaudhary A, Saleem A, Faisal MS, Samad M, Faisal MS, Dang D, Zuchelli T, Singla S. ADVERSE EVENTS RELATED TO ERCP WITH CHOLANGIOSCOPY IN LIVER TRANSPLANT RECIPIENTS. Gastrointest Endosc 2024; 99(6):AB636-AB637.
Document Type
Conference Proceeding
Publication Date
6-1-2024
Publication Title
Gastrointest Endosc
Abstract
Introduction: Adverse events (AE) after endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant (LT) recipients have been evaluated in the past, with overall AE rates similar to that of non-LT recipients 1 . Cholangioscopy has been a helpful tool in the LT recipient population to assist with: precise ductal access, stone management, and evaluation of biliary strictures. To our knowledge, we present the first study analyzing rates of AE in post-LT patients who underwent ERCP with cholangioscopy. Methods: This was designed as a single center retrospective cohort study. LT recipients who underwent ERCP from 2015-2023 were identified using ICD-9/10CM diagnosis codes. These patients were then cross-referenced with an endoscopic procedure database to identify LT recipients who underwent ERCP with cholangioscopy. We compared outcomes and AE of patients who underwent ERCP with and without cholangioscopy. Results: A total of 29 LT recipients were identified who underwent ERCP with cholangioscopy and 70 LT recipients who underwent ERCP without cholangioscopy (selected control population, age and-gender matched) between 2015 and 2023. The most common indication for ERCP in these populations was for evaluation of biliary stricture seen on imaging (35% in cases and 32% in controls). The most common finding was biliary stricture in the cholangioscopy (77.8%) and non-cholangioscopy (58%) groups. There was a statistically significant difference in procedure times in the cholangioscopy (90.48 +/- 39.1 minutes) and non-cholangioscopy (49.65 +/- 28.9 minutes) groups (P-value: <0.01). The most common indications for cholangioscopy included: need for precise biliary access (62%), optimal evaluation of stricture/rule out malignancy (21%) and stone management (7%). AE occurred in 7 procedures (10%) in the control group: bleeding (2.9%), infection (5.7%), perforation (2.9%), pancreatitis (1.4%). AE occurred in 1 procedure (3.4%) in the cholangioscopy group: infection (3.4%). The rate of AE was not significantly different among both groups (p-value 0.43). Conclusion: Overall rates of AE were not significantly different between the LT recipients who underwent ERCP with cholangioscopy and those who underwent ERCP without cholangioscopy. The procedure time was significantly longer in the cholangioscopy group. The potential risks of longer procedure and fluoroscopy time as well as possible increased cost to the patient should be weighed carefully against the potential benefits when determining need for cholangioscopy during ERCP in this population.
Volume
99
Issue
6
First Page
AB636
Last Page
AB637
