PMID- 34963021
OWN - NLM
STAT- MEDLINE
DCOM- 20220907
LR  - 20221015
IS  - 1443-1661 (Electronic)
IS  - 0915-5635 (Print)
IS  - 0915-5635 (Linking)
VI  - 34
IP  - 6
DP  - 2022 Sep
TI  - Multicenter prospective cohort study of adverse events associated with biliary 
      endoscopic retrograde cholangiopancreatography: Incidence of adverse events and 
      preventive measures for post-endoscopic retrograde cholangiopancreatography 
      pancreatitis.
PG  - 1198-1204
LID - 10.1111/den.14225 [doi]
AB  - OBJECTIVES: The reported incidence of adverse events (AEs) in endoscopic 
      retrograde cholangiopancreatography (ERCP) varies between 2.5% and 14%. The aim 
      of this study was to evaluate the incidence and severity of AEs in biliary ERCP 
      and to specify the risk factors and preventive measures for post-ERCP 
      pancreatitis (PEP). METHODS: Patients with biliary disease with intact papilla 
      were prospectively enrolled at 36 hospitals between April 2017 and March 2018. 
      The primary outcomes were the incidence and severity of AEs. RESULTS: A total of 
      16,032 ERCP procedures were performed at the 36 hospitals during the study period 
      and 3739 patients were enrolled. The overall incidence of AEs was 10.1% and 
      ERCP-related mortality was 0.08%. PEP developed in 258 cases (6.9%), bleeding in 
      33 (0.9%), instrumental AEs in 17 (0.5%), infections in 37 (1.0%), cardiovascular 
      AEs in eight (0.2%), pulmonary AEs in eight (0.2%), drug reaction AE in one 
      (0.03%), pain in 15 (0.4%), and other AEs in 15 (0.4%). Multivariable analysis 
      showed significant risk factors for PEP were: female of younger age, pancreatic 
      guidewire-assisted biliary cannulation, temporary guidewire insertion into the 
      pancreatic duct, total procedure time >60 min, and post-ERCP administration of 
      non-steroidal anti-inflammatory drugs. Effective preventive measures were 
      prophylactic pancreatic stenting (PPS) and epinephrine spraying onto the papilla. 
      CONCLUSIONS: In patients with intact papilla who underwent biliary ERCP, the 
      incidence of AEs was 10.1% and the mortality was 0.08%. PPS and epinephrine 
      spraying may prevent PEP. REGISTRATION: This study was registered in the 
      University Hospital Medical Information Network (UMIN000024820).
CI  - (c) 2021 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, 
      Ltd on behalf of Japan Gastroenterological Endoscopy Society.
FAU - Fujita, Koichi
AU  - Fujita K
AUID- ORCID: 0000-0002-0768-1801
AD  - Department of Gastroenterology and Hepatology, Yodogawa Christian Hospital, 
      Osaka, Japan.
AD  - First Research Department, Tazuke Kofukai Medical Research Institute, Osaka, 
      Japan.
FAU - Yazumi, Shujiro
AU  - Yazumi S
AUID- ORCID: 0000-0002-0683-0000
AD  - Department of Gastroenterology and Hepatology, Kitano Hospital, Osaka, Japan.
FAU - Matsumoto, Hisakazu
AU  - Matsumoto H
AUID- ORCID: 0000-0003-1772-8447
AD  - Department of Gastroenterology, Japanese Red Cross Hospital Wakayama Medical 
      Center, Wakayama, Japan.
FAU - Asada, Masanori
AU  - Asada M
AUID- ORCID: 0000-0002-7478-7649
AD  - Department of Gastroenterology and Hepatology, Japanese Red Cross Osaka Hospital, 
      Osaka, Japan.
FAU - Nebiki, Hiroko
AU  - Nebiki H
AUID- ORCID: 0000-0002-4815-1831
AD  - Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan.
FAU - Matsumoto, Kazuya
AU  - Matsumoto K
AUID- ORCID: 0000-0002-5680-4791
AD  - Division of Gastroenterology and Nephrology, Department of Multidisciplinary 
      Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.
FAU - Maruo, Toru
AU  - Maruo T
AD  - Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, 
      Japan.
FAU - Takenaka, Mamoru
AU  - Takenaka M
AUID- ORCID: 0000-0001-7308-4311
AD  - Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan.
FAU - Tomoda, Takeshi
AU  - Tomoda T
AD  - Department of Gastroenterology and Hepatology, Okayama University Graduate School 
      of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
FAU - Onoyama, Takumi
AU  - Onoyama T
AUID- ORCID: 0000-0003-0310-0720
AD  - Division of Gastroenterology and Nephrology, Department of Multidisciplinary 
      Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.
FAU - Kurita, Akira
AU  - Kurita A
AUID- ORCID: 0000-0003-3047-7662
AD  - Department of Gastroenterology and Hepatology, Kitano Hospital, Osaka, Japan.
FAU - Ueki, Toshiharu
AU  - Ueki T
AUID- ORCID: 0000-0002-4142-5895
AD  - Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, 
      Japan.
FAU - Katayama, Toshiro
AU  - Katayama T
AUID- ORCID: 0000-0001-9059-8509
AD  - Department of Medical Engineering, Faculty of Health Sciences, Morinomiya 
      University of Medical Sciences, Osaka, Japan.
AD  - Help Center of Medical Research, Tazuke Kofukai Medical Research Institute, 
      Osaka, Japan.
FAU - Kawamura, Takashi
AU  - Kawamura T
AUID- ORCID: 0000-0002-4539-1338
AD  - Kyoto University Health Service, Kyoto, Japan.
FAU - Kawamoto, Hirofumi
AU  - Kawamoto H
AUID- ORCID: 0000-0002-9650-3555
AD  - General Internal Medicine 2, Kawasaki Medical School General Medical Center, 
      Okayama, Japan.
CN  - Bilio-pancreatic Study Group of West Japan
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220204
PL  - Australia
TA  - Dig Endosc
JT  - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy 
      Society
JID - 9101419
RN  - YKH834O4BH (Epinephrine)
SB  - IM
CIN - Dig Endosc. 2022 Sep;34(6):1205-1206. PMID: 35318750
MH  - *Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods
MH  - Epinephrine
MH  - Female
MH  - Humans
MH  - Incidence
MH  - *Pancreatitis/epidemiology/etiology/prevention & control
MH  - Prospective Studies
MH  - Risk Factors
PMC - PMC9540598
OTO - NOTNLM
OT  - cholangiopancreatography
OT  - endoscopic retrograde
OT  - pancreatitis
COIS- Authors declare no conflict of interest for this article.
EDAT- 2021/12/29 06:00
MHDA- 2022/09/08 06:00
PMCR- 2022/10/07
CRDT- 2021/12/28 17:20
PHST- 2021/12/18 00:00 [revised]
PHST- 2021/06/14 00:00 [received]
PHST- 2021/12/27 00:00 [accepted]
PHST- 2021/12/29 06:00 [pubmed]
PHST- 2022/09/08 06:00 [medline]
PHST- 2021/12/28 17:20 [entrez]
PHST- 2022/10/07 00:00 [pmc-release]
AID - DEN14225 [pii]
AID - 10.1111/den.14225 [doi]
PST - ppublish
SO  - Dig Endosc. 2022 Sep;34(6):1198-1204. doi: 10.1111/den.14225. Epub 2022 Feb 4.