caa a22 4500 44579478X CHVBK 20180317145121.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1830-8 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1830-8 Comorbidities, Sphincterotomy, and Balloon Dilation Predict Post-ERCP Adverse Events in PSC Patients: Operator Experience Is Protective [Elektronische Daten] [Amer Alkhatib, Kristen Hilden, Douglas Adler] Background: Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease. Interventional ERCP improves survival in PSC patients. Aims: To describe the frequency and risk factors for post-ERCP adverse events in patients with PSC via multivariate analysis. Methods: Retrospective cohort study included patients with a diagnosis of PSC who underwent ERCP at academic institutions between February 2000 and October 2009. Demographis, co-morbid conditions, antibiotic use, cannulation method, ERCP maneuvers and 30-day post-ERCP adverse events were collected. Multivariate analysis was performed using logistic regression. Results: A total of 185 procedures were performed on 75 PSC patients (58M,17 F). Seven endoscopists performed ERCPs. Comorbidies included ulcerative colitis (44%, n=33), Crohn's disease (12%, n=9 patients), Cirrhosis (8%, n=6 patients) and autoimmune hepatitis (2.7%, n=2). Cannulation was achieved using dye-free guidewire cannulation techniques in 139/185 procedures (76%) and with contrast-based techniques in 46/185 procedures (24%). Thirty-day post-ERCP adverse events included post-ERCP pancreatitis (5%, n=9, cholangitis (1%, n=2), acute cholecystitis (0.5%, n=1), stent occlusion (0.5%, n=1), stent migration (0.5%, n=1), and bile leak (0.5%, n=1). In the multivariate analysis, associations with specific endoscopists who performed the procedure (P=0.01), biliary dilation (P=0.02), sphincterotomy (P=0.03), presence of cirrhosis (P=0.05), Crohn's disease (P<0.001), and autoimmune hepatitis (P<0.001) significantly predicted a complication following ERCP. Gender, stenting during procedure, presence of a dominant stricture, and cholangitis were not predictive for post-ERCP adverse events. Conclusions: Factors predicting 30-day post-ERCP adverse events included certain co-morbid conditions, the endoscopist ERCP volume, maneuvers during ERCP including dilation and sphincterotomy. Stenting was not associated with adverse events. Springer Science+Business Media, LLC, 2011 Cholangitis, primary sclerosing nationallicence Cholangiopancreatoscopy, endoscopic retrograde nationallicence Pancreatitis nationallicence Sphincterotomy, endoscopic nationallicence Alkhatib Amer Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut Hilden Kristen Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut Adler Douglas Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3685-3688 0163-2116 56:12<3685 2011 56 10620 https://doi.org/10.1007/s10620-011-1830-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1830-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Alkhatib Amer Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut NATIONALLICENCE 700 1- Hilden Kristen Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut NATIONALLICENCE 700 1- Adler Douglas Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, 84132, Salt Lake City, UT, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3685-3688 0163-2116 56:12<3685 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer