Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study

İbiş, Mehmet; Yuksel, Ilhami; ŞAHİN, Burhan; PARLAK, Erkan; ŞAŞMAZ, Nurgül; Ataseven, Hilmi; Cicek, Bahattin; ERTUĞRUL, İbrahim; Başar, Ömer

Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study

İbrahim ERTUĞRUL, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

İlhami YÜKSEL, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Erkan PARLAK, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Bahattin ÇİÇEK, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Hilmi ATASEVEN, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Ömer BAŞAR, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Mehmet İBİŞ, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Nurgül ŞAŞMAZ, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Burhan ŞAHİN (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)

Turkish Journal of Gastroenterology

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Yıl: 2009 Cilt: 20 Sayı: 2 Sayfa Aralığı: 116 - 121 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study

Öz:

Amaç: Kolanjit, endoskopik biliyer drenajın en morbid komplikasyonlarından biridir. Aynı zamanda endoskopik retrograt pankreatikografi ile ilişkili ölümün en sık sebepleri arasındadır. Bu prospektif çalışmanın amacı endoskopik retrograt pankreatikografi sonrası kolanjit gelişiminde risk faktörlerini araştırmaktır. Yöntem: Çalışmaya endoskopik retrograt pankreatikografi yapılan naif papillalı 503 hasta alındı. Tüm hastalarda endoskopik retrograt pankreatikografiden sonra 72 saat içinde gelişen kolanjit dahil edildi. Tüm hastalara endoskopik retrograt pankreatikografiden önce antibiyotik proflaksisi verildi. Post-endoskopik retrograt pankreatikografi kolanjitte risk faktörleri olarak yaş, cinsiyet, prezentasyon, papillanın durumu, terapötik prosedürler ve tanılar analiz edildi. Bulgular: Ortalama yaş 61.2 ± 14.8 idi. 274'ü (%54.5) kadın, 229'u (%45.5) erkek idi. Post-endoskopik retrograt pankreatikografi kolanjit 17 hastada (%3.3) (9 kadın and 8 erkek) gelişti. Postendoskopik retrograt pankreatikografi kolanjit gelişiminde en sık hiler kolanjiokarsinomu risk faktörü olarak saptandı. Postendoskopik retrograt pankreatikografi kolanjit riski biliyer dilatasyon, biliyer stent uygulaması ve periampuller divertikül olmayanlarda anlamlı olarak daha yüksek bulundu (sırasıyla, OR: 4.8, 4.4, 1.2). Kolanjit gelişenlerde total işlem süresi anlamlı olarak daha uzundu ve koledok çapı da anlamlı olarak artmış idi. Endoskopik retrograt pankreatikografi sonrası sepsis nedeniyle 5 hasta (3 kadın, 2 erkek; 0.9%) öldü. Sonuç: Artmış koledok çapı, biliyer dilatasyon, biliyer stent uygulaması, total işlem süresi ve hiler kolanjiokarsinoma post-endoskopik retrograt pankreatikografi kolanjitte artmış risk faktörleri olarak bulundu. Ayrıca, periampuller divertikül varlığında kolanjit riskinin azaldığı saptandı.

Anahtar Kelime: Kolanjiyopankreatografi, endoskopik retrograd İleriye dönük çalışma Risk faktörleri Hastaneler, araştırma Birleşik safra kanalı Kolanjit Stentler Drenaj Protez implantasyonu

Konular: Cerrahi

Post-ercp kolanjitte risk faktörleri: Prospektif çalışma

Öz:

Background/aims: Cholangitis is one of the most morbid complications of endoscopic biliary drainage and among the commonest causes of endoscopic retrograde cholangiopancreatography- related death. The aim of this prospective study was to investigate the risk factors for the development of cholangitis after endoscopic retrograde cholangiopancreatography in a tertiary referral center. Methods: The study involved 503 consecutive patients with naive papilla who underwent endoscopic retrograde cholangiopancreatography. We included the cholangitis occurring within 72 hours after endoscopic retrograde cholangiopancreatography for all patients undergoing the procedure. All patients received antibiotic prophylaxis before endoscopic retrograde cholangiopancreatography. Factors including age, gender, presentation, nature of the papilla, therapeutic procedures, and the diagnosis were analyzed to predict post-endoscopic retrograde cholangiopancreatography cholangitis. Results: Median age was 61.2 ± 14.8 years and there were 274 (54.5%) women and 229 (45.5%) men. Seventeen (3.3%) patients (9 F, 8 M) developed cholangitis after endoscopic retrograde cholangiopancreatography. The risk of post-endoscopic retrograde cholangiopancreatography cholangitis development was most probable in patients with hilar cholangiocarcinoma. Post-endoscopic retrograde cholangiopancreatography cholangitis risk was significantly higher in patients with biliary dilatation and biliary stent insertion, and without periampullary diverticula (odds ratio, OR: 4.8, 4.4, 1.2, respectively). Total procedure duration was significantly prolonged and common bile duct diameter was significantly increased in patients who had cholangitis. Five patients (3 F, 2 M; 0.9%) died because of post-endoscopic retrograde cholangiopancreatography complicated sepsis. Conclusions: Increased common bile duct diameter, biliary dilatation, biliary stent insertion, prolonged total procedure time, and hilar cholangiocarcinoma have higher post-endoscopic retrograde cholangiopancreatography cholangitis risk. Moreover, the presence of periampullary diverticula was found to decrease cholangitis risk.

Anahtar Kelime: Common Bile Duct Cholangitis Stents Drainage Prosthesis Implantation Cholangiopancreatography, Endoscopic Retrograde Prospective Studies Risk Factors Hospitals, Teaching

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ERTUĞRUL İ, Yuksel I, PARLAK E, Cicek B, Ataseven H, Başar Ö, İbiş M, ŞAŞMAZ N, ŞAHİN B (2009). Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. , 116 - 121.
Chicago	ERTUĞRUL İbrahim,Yuksel Ilhami,PARLAK Erkan,Cicek Bahattin,Ataseven Hilmi,Başar Ömer,İbiş Mehmet,ŞAŞMAZ Nurgül,ŞAHİN Burhan Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. (2009): 116 - 121.
MLA	ERTUĞRUL İbrahim,Yuksel Ilhami,PARLAK Erkan,Cicek Bahattin,Ataseven Hilmi,Başar Ömer,İbiş Mehmet,ŞAŞMAZ Nurgül,ŞAHİN Burhan Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. , 2009, ss.116 - 121.
AMA	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. . 2009; 116 - 121.
Vancouver	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. . 2009; 116 - 121.
IEEE	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B "Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study." , ss.116 - 121, 2009.
ISNAD	ERTUĞRUL, İbrahim vd. "Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study". (2009), 116-121.

APA	ERTUĞRUL İ, Yuksel I, PARLAK E, Cicek B, Ataseven H, Başar Ö, İbiş M, ŞAŞMAZ N, ŞAHİN B (2009). Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. Turkish Journal of Gastroenterology, 20(2), 116 - 121.
Chicago	ERTUĞRUL İbrahim,Yuksel Ilhami,PARLAK Erkan,Cicek Bahattin,Ataseven Hilmi,Başar Ömer,İbiş Mehmet,ŞAŞMAZ Nurgül,ŞAHİN Burhan Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. Turkish Journal of Gastroenterology 20, no.2 (2009): 116 - 121.
MLA	ERTUĞRUL İbrahim,Yuksel Ilhami,PARLAK Erkan,Cicek Bahattin,Ataseven Hilmi,Başar Ömer,İbiş Mehmet,ŞAŞMAZ Nurgül,ŞAHİN Burhan Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. Turkish Journal of Gastroenterology, vol.20, no.2, 2009, ss.116 - 121.
AMA	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. Turkish Journal of Gastroenterology. 2009; 20(2): 116 - 121.
Vancouver	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study. Turkish Journal of Gastroenterology. 2009; 20(2): 116 - 121.
IEEE	ERTUĞRUL İ,Yuksel I,PARLAK E,Cicek B,Ataseven H,Başar Ö,İbiş M,ŞAŞMAZ N,ŞAHİN B "Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study." Turkish Journal of Gastroenterology, 20, ss.116 - 121, 2009.
ISNAD	ERTUĞRUL, İbrahim vd. "Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: A prospective study". Turkish Journal of Gastroenterology 20/2 (2009), 116-121.