There are conflicting data regarding the role of ERCP in patients with primary sclerosing cholangitis and the risk of procedure-related complications.
Dr Jason Etzel and colleagues from Washington, USA evaluated the complication rate after ERCP in a consecutive series of patients with primary sclerosing cholangitis.
Control patients had biliary strictures who did not have primary sclerosing cholangitis.
|There was no difference in the rate of complications in diagnostic vs therapeutic ERCPs|
The team conducted a retrospective cross-sectional study at a tertiary referral academic hospital
The team assessed incidence of complications after ERCP.
The researchers reviewed a total of 85 ERCPs among 30 patients with primary sclerosing cholangitis, and 70 ERCPs among 45 control patients.
There was no significant difference in the overall complication rates between patients with and without primary sclerosing cholangitis.
The team found complications in primary sclerosing cholangitis were more likely to occur after ERCP done to evaluate an acute sign or symptom than in elective cases.
Patients with primary sclerosing cholangitis who had complications had more total and acute ERCPs than did those without complications.
There was no significant difference in the rate of complications in diagnostic versus therapeutic ERCPs.
The researchers did not identify significant differences between stent placement and dilation-only therapeutic ERCPs in the primary sclerosing cholangitis population.
Dr Etzel's team concluded, "Elective ERCP is safe and carries a modest risk in patients with primary sclerosing cholangitis."
"However, ERCP for acute indications greatly increases the probability of postprocedure complications."
"The overall complication rate after therapeutic ERCP in patients with primary sclerosing cholangitis is similar to that in patients without primary sclerosing cholangitis."