ABSTRACT
Background:
ERCP can lead to complications, which can be prevented by the recognition of risk factors.
Aim:
To identify these risk factors, with quality evaluation.
Methods:
Retrospective study in a Brazilian hospital in 194 patients, excluding surgically altered anatomy.
Results:
211 ERCPs were performed: 97.6% were therapeutic, 83.4% were started by trainees, with deep cannulation rate of 89.6%. Precut was needed in 16.6% of the ERCPs and classic sphincterotomy in 67.3%, with 75.4% of ductal clearance at single session and 8.0% of technical failure. Inacessible papillas ocurred in 2.5% of cases. There were 2.5% of late complications and 16% of early complications. Multivariate analysis identified six predictors for early complications: fistulotomy precut (OR=3.4, p=0.010), difficult cannulation (OR=21.5, p=0.002), attending’s procedural time (OR=2.4, p=0.020), choledocholithiasis (adjusted OR=1.8, p=0.015), cannulation time (adjusted OR=3.2, p=0.018) and ERCP duration (adjusted OR=2.7, p=0.041).
Conclusion:
Six risk factors for post-ERCP complications were identified. ERCP duration and cannulation time are suggested as new potential quality indicators.
HEADINGS:
Risk factors; Postoperative complications; Qualityindicators, healthcare; Endoscopy, gastrointestinal.