Revista do Colégio Brasileiro de Cirurgiões
Print version ISSN 0100-6991
DAHER FILHO, Presper F. et al. Evaluation of ERCP-related morbidity in patients with choledocholithiasis suspicion. Rev. Col. Bras. Cir. [online]. 2007, vol.34, n.2, pp. 114-118. ISSN 0100-6991. http://dx.doi.org/10.1590/S0100-69912007000200009.
BACKGROUND: To determine the predictors of complications resulting from endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis. METHODS: Data were retrospectively collected from August 1999 to January 2005. Patients with clinical diagnosis of choledocholithiasis were included. Patients with tumours of the biliary tree or pancreas were excluded. The authors evaluated the procedure success and the risk factors associated with post-ERCP complications such as acute pancreatitis, hemorrhage, cholangitis, perforation, vomits and hyperamylasemia, and their association with the procedures. Student's t test, the Chi-square and the Fisher exact test were applied to the statistical analysis, considering p< 0.05 as significant. RESULTS: There were 178 patients (52 men and 156 women, mean age 54.3 + 19.3) included in the analysis. Choledocholithiasis was found in 124 patients (69.7%) and the sucess rate of the procedure was 74.2% (92 patients). Post-ERCP complications occurred in 19 patients (10.7%). Six patients (3.4%) had acute pancreatitis, four had hemorrhage from the papilla (2.2%), two had cholangitis (1.1%), one had duodenal perforation (0.6%), and other four had vomiting without pancreatitis (2.2%). Two patients had other clinical complications. The main pancreatic duct catheterization was identified as a risk factor for the development of acute pancreatitis after ERCP (p=0,004). CONCLUSION: Pancreatic duct catheterization during ERCP significantly increases the risk of acute pancreatitis post-ERCP.
Keywords : Choledocholithiasis; Cholangiopancreatography, endoscopic retrograde; Cholangiopancreatography, endoscopic retrograde [statistics & numerical data]; Pancreatitis.