Risks of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis After Liver Transplantation

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-07-18 DOI:10.1111/ctr.15399

Kimia Ghambari, David M. de Jong, Marco J. Bruno, Wojciech G. Polak, Lydi M. J. W. van Driel, Caroline M. den Hoed

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Abstract

Biliary complications are common after liver transplantation (LT). Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred method to treat biliary complications. Nevertheless, ERCP is not without complications and may have a greater complication rate in the LT population. Knowledge of the prevalence, severity, and possible risk factors for post-ERCP pancreatitis (PEP) in LT recipients is limited. Therefore, this study aims to determine the incidence and severity of PEP and identify potential risk factors in LT recipients. This retrospective cohort included patients ≥18 years who underwent ≥1 ERCP procedures after LT between January 2010 and October 2021. Two hundred thirty-two patients were included, who underwent 260 LTs and 1125 ERCPs. PEP occurred after 23 ERCP procedures (2%) with subsequent mortality in three (13%). Multivariate logistic regression identified wire cannulation of the pancreatic duct as a significant risk factor for PEP (OR, 3.21). The complication rate of PEP after LT in this study was shown to be low and is lower compared to patients without a history of LT. Nevertheless, the mortality rate of this group of patients was notably higher.

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肝移植后内镜逆行胰胆管造影术后胰腺炎的风险。

胆道并发症是肝移植（LT）后的常见并发症。内镜逆行胰胆管造影术（ERCP）是治疗胆道并发症的首选方法。然而，ERCP并非没有并发症，在LT人群中并发症发生率可能更高。关于ERCP术后胰腺炎（PEP）在LT受术者中的发生率、严重程度和可能的风险因素的知识还很有限。因此，本研究的目的是确定PEP在LT受者中的发生率和严重程度，并找出潜在的风险因素。这项回顾性队列研究纳入了在2010年1月至2021年10月期间接受过LT术后≥1次ERCP手术、年龄≥18岁的患者。共纳入 232 名患者，他们接受了 260 次 LT 和 1125 次 ERCP。23 例 ERCP 术后发生了 PEP（2%），其中 3 例（13%）随后死亡。多变量逻辑回归确定胰管钢丝插管是 PEP 的重要风险因素（OR，3.21）。本研究显示，LT 后 PEP 的并发症发生率较低，与无 LT 病史的患者相比也较低。然而，该组患者的死亡率明显较高。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.