Long-term prognosis and risk factors associated with 30-day unplanned repeated ERCP in patients with common bile duct stones
Background: The unplanned repeated endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct stone (CBDS) remains unclear. Objectives: To identify risk factors of unplanned repeated ERCP and its impact on clinical outcomes. Design: Retrospective cohort study. Methods: P...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-06-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848251342342 |
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| Summary: | Background: The unplanned repeated endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct stone (CBDS) remains unclear. Objectives: To identify risk factors of unplanned repeated ERCP and its impact on clinical outcomes. Design: Retrospective cohort study. Methods: Patients who underwent ERCP for CBDSs from January 2013 to October 2023 were consecutively reviewed. Risk factors for unplanned repeated ERCP within 1 month were evaluated using logistic regression. The impact of unplanned repeated ERCP on adverse events, including ampullary bleeding, CBDSs recurrence, and biliary infection, was explored. Results: A total of 1241 patients were included, of which 50 patients underwent unplanned repeated ERCP in 1 month primarily because of unrelieved biliary obstruction or cholangitis. The repeated ERCP group had higher proportions of irregular papilla (42.0% vs 21.7%, p < 0.001), stones locating in superior common bile duct (CBD; 18.0% vs 8.8%, p = 0.05), larger CBD diameter (median 1.2 vs 1.0 cm, p = 0.002), or larger CBDS diameter (median 1.0 vs 0.8 cm, p = 0.004) than the unrepeated group. In the multivariate analysis, irregular papilla (odds ratio (OR) 3.494, p = 0.024), post-ERCP fever (OR 7.532, p < 0.001), post-ERCP abdominal pain (OR 2.810, p = 0.05), post-/pre-ERCP total bilirubin levels ⩾1.2 times (OR 6.973, p = 0.007), and post-/pre-ERCP transaminase levels ⩾1.2 times (OR 3.944, p = 0.026) were independent risk factors for unplanned repeated ERCP. The incidence of adverse events in the long term was higher in the repeated group than the unrepeated group (12.0% vs 5.0%, p = 0.068). Unplanned repeated ERCP, although not an independent factor, is partially relevant with increased likelihood of long-term adverse events (univariate OR 2.570, p = 0.038). Conclusion: Papillary morphology, post-ERCP symptoms, and serum biochemical parameters may help predict the occurrence of unplanned repeated ERCP in patients with CBDS. Unplanned repeated ERCP does not have a significant impact on the long-term prognosis. |
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| ISSN: | 1756-2848 |