Endoscopic retrograde cholangiopancreatography-related adverse events in Korea: A nationwide assessment

Dong Kee Jang, Jungmee Kim, Chang Nyol Paik, Jung Wook Kim, Tae Hee Lee, Jae Young Jang, Seung Bae Yoon, Jun Kyu Lee

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

Background: Although endoscopic retrograde cholangiopancreatography (ERCP) is a pivotal procedure for the diagnosis and treatment of a variety of pancreatobiliary diseases, it has been known that the risk of procedure-related adverse events (AEs) is significant. Objective: We conducted this nationwide cohort study since there have been few reports on the real-world data regarding ERCP-related AEs. Methods: Patients who underwent ERCP were identified between 2012 and 2015 using Health Insurance Review and Assessment database generated by the Korea government. Incidence, annual trends, demographics, characteristics according to the types of procedures, and the risk factors of AEs were assessed. Results: A total of 114,757 patients with male gender of 54.2% and the mean age of 65.0 ± 15.2 years were included. The most common indication was choledocholithiasis (49.4%) and the second malignant biliary obstruction (22.8%). Biliary drainage (33.9%) was the most commonly performed procedure, followed by endoscopic sphincterotomy (27.4%), and stone removal (22.0%). The overall incidence of ERCP-related AEs was 4.7% consisting of post-ERCP pancreatitis (PEP; 4.6%), perforation (0.06%), and hemorrhage (0.02%), which gradually increased from 2012 to 2015. According to the type of procedures, ERCP-related AEs developed the most commonly after pancreatic stent insertion (11.4%), followed by diagnostic ERCP (5.9%) and endoscopic sphincterotomy (5.7%). Younger age and diagnostic ERCP turned out to be independent risk factors of PEP. Conclusions: ERCP-related AEs developed the most commonly after pancreatic stent insertion, diagnostic ERCP and endoscopic sphincterotomy. Special caution should be used for young patients receiving diagnostic ERCP due to increased risk of PEP.

Original languageEnglish
Pages (from-to)73-79
Number of pages7
JournalUnited European Gastroenterology Journal
Volume10
Issue number1
DOIs
Publication statusPublished - Feb 2022

Bibliographical note

Publisher Copyright:
© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

Keywords

  • Korea
  • complication
  • endoscopic retrograde cholangiopancreatography
  • hemorrhage
  • pancreatitis
  • perforation

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