PMID- 38094034
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231214
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 12
DP  - 2023 Dec
TI  - Antibiotic prophylaxis and post-procedure infectious complications in endoscopic 
      retrograde cholangiopancreatography with peroral cholangioscopy.
PG  - E1177-E1183
LID - 10.1055/a-2210-6283 [doi]
AB  - Background and study aims Single-operator peroral cholangioscopy (SOC) has gained 
      increasing attention in modern biliary and pancreatic therapy and diagnosis. This 
      procedure has shown higher rates of infectious complications than conventional 
      endoscopic retrograde cholangiopancreatography (ERCP); therefore, many guidelines 
      recommend antibiotic prophylaxis (AP). However, whether AP administration 
      decreases infectious or overall adverse events (AEs) has been little studied. We 
      aimed to study whether AP affects post-procedure infectious or overall AEs in 
      ERCP with SOC. Patients and methods We collected data from the Swedish Registry 
      for Gallstone Surgery and ERCP (GallRiks). Of the 124,921 extracted ERCP 
      procedures performed between 2008 and 2021, 1,605 included SOC and represented 
      the study population. Exclusion criteria were incomplete 30-day follow-up, 
      ongoing antibiotic use, and procedures with unspecified indication. Type and dose 
      of antibiotics were not reported. Post-procedure infectious complications and AEs 
      at 30-day follow-up were the main outcomes. Results AP was administered to 1,307 
      patients (81.4%). In this group, 3.4% of the patients had infectious 
      complications compared with 3.7% in the non-AP group. The overall AE rates in the 
      AP and non-AP groups were 14.6% and 15.2%, respectively. The incidence of 
      cholangitis was 3.1% in the AP group and 3.4% in the non-AP group. Using 
      multivariable analysis, both infectious complications (odds ratio [OR] 0.92, 95% 
      confidence interval [CI] 0.54-1.57) and AEs (OR 0.87, 95% CI 0.65-1.16) remained 
      unaffected by AP administration. Conclusions No reduction in infectious 
      complication rates and AEs was seen with AP administration for SOC. The continued 
      need for AP in SOC remains uncertain.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial-License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Gustafsson, Arvid
AU  - Gustafsson A
AUID- ORCID: 0000-0001-7281-9945
AD  - Department of Clinical Sciences Lund, Surgery, Lund University and Department of 
      Surgery, Skane University Hospital, Lund, Sweden.
AD  - Department of Research and Development and Department of Surgery, Central 
      Hospital, Region Kronoberg, Vaxjo, Sweden.
FAU - Enochsson, Lars
AU  - Enochsson L
AD  - Department of Surgical and Perioperative Sciences, Surgery, Umea University, 
      Umea, Sweden.
FAU - Tingstedt, Bobby
AU  - Tingstedt B
AD  - Department of Clinical Sciences Lund, Surgery, Lund University and Department of 
      Surgery, Skane University Hospital, Lund, Sweden.
FAU - Olsson, Greger
AU  - Olsson G
AD  - Department of Research and Development and Department of Surgery, Central 
      Hospital, Region Kronoberg, Vaxjo, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20231213
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10719045
OTO - NOTNLM
OT  - Cholangioscopy
OT  - ERC topics
OT  - Pancreatoscopy
OT  - Stones
OT  - Strictures
COIS- Conflict of Interest The authors declare that they have no conflict of interest.
EDAT- 2023/12/14 06:42
MHDA- 2023/12/14 06:43
PMCR- 2023/12/01
CRDT- 2023/12/14 04:07
PHST- 2023/08/10 00:00 [received]
PHST- 2023/11/06 00:00 [accepted]
PHST- 2023/12/14 06:43 [medline]
PHST- 2023/12/14 06:42 [pubmed]
PHST- 2023/12/14 04:07 [entrez]
PHST- 2023/12/01 00:00 [pmc-release]
AID - EIO-2023-08-3096-OA [pii]
AID - 10.1055/a-2210-6283 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Dec 13;11(12):E1177-E1183. doi: 10.1055/a-2210-6283. 
      eCollection 2023 Dec.