Dissemin is shutting down on January 1st, 2025

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SAGE Publications, Scandinavian Journal of Surgery, 2(104), p. 86-91, 2014

DOI: 10.1177/1457496914529274

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Post-Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

Journal article published in 2014 by R. B. Ambrus, L. B. Svendsen ORCID, J. G. Hillingsø, M. L. Hansen, M. P. Achiam
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Background: Complications in the biliary tract occur in 5%−30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. Methods: Retrospective study of all ERCPs performed in liver transplantation patients during a 9-year period. Results: A total of 292 ERCPs were included. Overall post-ERCP complications occurred in 24 procedures (8.2%): pancreatitis in 8 (2.7%), bleeding in 5 (1.7%), and cholangitis in 13 (4.5%) procedures. Simultaneous pancreatitis and cholangitis, and simultaneous bleeding and cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy ( p = 0.006) and time since liver transplantation within 90 days postoperatively ( p = 0.044) as risk factors for post-ERCP complications. Specifically concerning post-ERCP pancreatitis (PEP), it was found that pre-ERCP cholangitis was another independent risk factor for PEP ( p = 0.026). Stent in the biliary tract prior to ERCP seemed to be protective ( p = 0.041). Conclusions: Complications were of surprisingly mild degree. The rates of post-ERCP complications in our study were in line with previous studies with liver transplantation patients. Cholangitis prior to ERCP may be another risk factor for post-ERCP pancreatitis.