Complications after ERCP in liver transplant recipients - 04/08/11
Reprint requests: Andres Cardenas, MD, MMSc, Institut de Malalties Digestives i Metaboliques, University of Barcelona, Hospital Clinic, Villarroel 170, Esc 3-2, 08036 Barcelona, SpainResumen |
Background |
Complications of the biliary tract after liver transplantation are successfully managed with ERCP; however, the incidence and risk factors for post-ERCP complications remain unknown.
Objective |
To examine the incidence, risk factors, and short-term outcome of post-ERCP complications in liver transplant (LT) recipients.
Design |
Retrospective evaluation of all ERCPs performed in LT recipients at our institution during a 7-year, 4-month period.
Setting |
Tertiary referral center.
Patients |
A total of 243 ERCPs performed in 121 LT recipients with duct-to-duct anastomosis.
Main Outcome Measurements |
Incidence of post-ERCP complications. Predictive factors were determined by univariate and multivariate analyses.
Results |
Overall complications occurred in 22 procedures (9%) (13 mild, 9 moderate): pancreatitis in 9 patients (3.7%), cholangitis in 8 patients (3.3%), postsphincterotomy bleeding in 4 patients (1.6%), and subcapsular hematoma in 1 patient (0.4%). The mean hospitalization for post-ERCP complications was 4.8 days (range 2-11 days). Logistic regression identified mammalian target of rapamycin inhibitors (odds ratio [OR], 4.65; 95% CI, 1.01-21.81; P = .049), serum creatinine level greater than 2 mg/dL (OR, 4.17; 95% CI, 1.07-16.26; P = .04), biliary sphincterotomy (OR, 3.03; 95% CI, 1.07-8.53; P = .037), and more than 2 pancreatic duct contrast injections (OR, 2.95; 95% CI, 1.10-7.91; P = .032) as independent risk factors for post-ERCP complications, whereas steroid therapy (OR, 0.23; 95% CI, 0.08-0.63; P = .004) was an independent protective factor.
Limitations |
Single-center retrospective study.
Conclusions |
The rate of complications after ERCP in LT recipients seems to be similar to that of non-LT recipients. Complications in this analysis were more common in LT recipients receiving mammalian target of rapamycin inhibitors and those with renal failure, biliary sphincterotomy, and more than 2 pancreatic duct injections, whereas they were less common in those patients on steroid therapy.
El texto completo de este artículo está disponible en PDF.Abbreviations : AS, LT, mTOR, NAS, OR, SOD
Esquema
| DISCLOSURE: The authors disclosed no financial relationships relevant to this publication. Drs Balderramo and Cardenas were funded in part by the Emili Letang grant from the Hospital Clínic of Barcelona. |
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| If you would like to chat with an author of this article, you may contact Dr. Cardenas at acardena@clinic.ub.es. |
Vol 74 - N° 2
P. 285-294 - août 2011 Regresar al número
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