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- Title
Bleeding Complications and Clinical Safety of Endoscopic Retrograde Cholangiopancreatography in Patients with Liver Cirrhosis.
- Authors
Ji Yeon Kim; Hee Seung Lee; Moon Jae Chung; Jeong Youp Park; Seung Woo Park; Si Young Song; Seungmin Bang
- Abstract
Purpose: Patients with liver cirrhosis are considered to be at risk for additional adverse events during endoscopic retrograde cholangiopancreatography (ERCP). The present study was designed as a propensity-score matched analysis to investigate whether cirrhotic liver increases the risk of bleeding complications in patients undergoing ERCP. Materials and Methods: In total, 8554 patients who underwent ERCP from January 2005 to December 2015 were retrospectively analyzed. To adjust for the imbalance between patients with and those without liver cirrhosis, 1:3 propensity score matching was performed according to age and sex. Results: Liver cirrhosis was identified in 264 (3.1%) patients. After propensity score matching, a total of 768 patients were included in each of the cirrhotic (n=192) and non-cirrhotic groups (n=576). Post-procedure bleeding (10.9% vs. 4.7%, p=0.003) was more frequently observed in patients with liver cirrhosis than in those without. In multivariate analyses, liver cirrhosis was identified as an independent risk factor associated with post-ERCP bleeding (p=0.003) after further adjustment for prothrombin time, antiplatelet/coagulant, duration of ERCP, and stent insertion. Child-Pugh (CP) class C was found to be associated with an increased incidence of post-ERCP bleeding in patients with cirrhosis (odds ratio 6.144, 95% confidence interval 1.320-28.606; p=0.021). Conclusion: The incidence of post-ERCP bleeding in patients with liver cirrhosis was higher than that in patients without liver cirrhosis. In particular, CP class C cirrhosis was significantly associated with post-ERCP bleeding.
- Subjects
ENDOSCOPIC retrograde cholangiopancreatography; CIRRHOSIS of the liver; PROPENSITY score matching; PROTHROMBIN time
- Publication
Yonsei Medical Journal, 2019, Vol 60, Issue 5, p440
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2019.60.5.440