Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study
Objective To evaluate the utilisation and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures, success rates, incidence and risk factors for procedural-related complications in a single centre-based study.Study design Retrospective cohort study.Setting First advanced tertiar...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e077806.full |
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| author | HusamEddin Z Salama Yousef A Alnajjar Tarek A Owais Afnan W M Jobran Ruaa Safi Mohammad Bahar Hazem Al-Ashhab |
| author_facet | HusamEddin Z Salama Yousef A Alnajjar Tarek A Owais Afnan W M Jobran Ruaa Safi Mohammad Bahar Hazem Al-Ashhab |
| author_sort | HusamEddin Z Salama |
| collection | DOAJ |
| description | Objective To evaluate the utilisation and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures, success rates, incidence and risk factors for procedural-related complications in a single centre-based study.Study design Retrospective cohort study.Setting First advanced tertiary endoscopy centre in Palestine.Participants A total of 1909 procedures on 1303 patients were included in the analysis: females were 57.9% of the cases (n=755), 1225 patients (94%) were from West Bank and Jerusalem and 78 (6%) were from Gaza Strip. All patients who underwent ERCP throughout the period from December 2017 to September 2022 were selected to participate in the study.Primary and secondary outcome measures The primary outcomes of interest in our analysis were success rates, procedural outcomes and post- procedural complications including pancreatitis, bleeding and others. Two multivariate logistic regression models were performed to calculate the risk of post-ERCP complications and post-ERCP pancreatitis (PEP) in patients with certain risk factors like demographic factors, procedural techniques' variation, pancreatic duct manipulations and others. We also discussed the management of the failed procedures.Results The overall complication rate was 5%, including PEP (n=43, 2.3%), infection/cholangitis (n=20, 1%), bleeding (n=9, 0.5%) and perforation (n=7, 0.4%). The mortality rate was 0.6% (n=11). Risk factors for adverse events included pancreatic duct cannulation and PEP (p<0.001, OR=3.64). Additionally, younger patients (≤45) were found to carry a higher risk for PEP when compared with older patients (≥65) (p=0.023, OR=2.84). In comparison with sphincterotomy, the double-wire technique was associated with a higher risk of complications (p=0.033, OR=2.29).Conclusions We summarised the utilisation and outcomes of ERCP among the Palestinian population in the first advanced centre in Palestine. Cannulation success rates are similar to the established standards and are acceptable compared with other centres worldwide. Perioperative complication rates of ERCP remain infrequent, and death is quite unusual and thus considered a safe procedure. |
| format | Article |
| id | doaj-art-5da99c91c7f6497b8a346fbf1d6ea6e5 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-5da99c91c7f6497b8a346fbf1d6ea6e52025-08-20T01:48:15ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-077806Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort studyHusamEddin Z Salama0Yousef A Alnajjar1Tarek A Owais2Afnan W M Jobran3Ruaa Safi4Mohammad Bahar5Hazem Al-Ashhab6Faculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Pharmacy, Beni-Suef University, Beni Suef, EgyptFaculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Medicine, Al-Quds University, Jerusalem, PalestineChief of Internal Medicine Department, Al-Quds University, Jerusalem, PalestineObjective To evaluate the utilisation and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures, success rates, incidence and risk factors for procedural-related complications in a single centre-based study.Study design Retrospective cohort study.Setting First advanced tertiary endoscopy centre in Palestine.Participants A total of 1909 procedures on 1303 patients were included in the analysis: females were 57.9% of the cases (n=755), 1225 patients (94%) were from West Bank and Jerusalem and 78 (6%) were from Gaza Strip. All patients who underwent ERCP throughout the period from December 2017 to September 2022 were selected to participate in the study.Primary and secondary outcome measures The primary outcomes of interest in our analysis were success rates, procedural outcomes and post- procedural complications including pancreatitis, bleeding and others. Two multivariate logistic regression models were performed to calculate the risk of post-ERCP complications and post-ERCP pancreatitis (PEP) in patients with certain risk factors like demographic factors, procedural techniques' variation, pancreatic duct manipulations and others. We also discussed the management of the failed procedures.Results The overall complication rate was 5%, including PEP (n=43, 2.3%), infection/cholangitis (n=20, 1%), bleeding (n=9, 0.5%) and perforation (n=7, 0.4%). The mortality rate was 0.6% (n=11). Risk factors for adverse events included pancreatic duct cannulation and PEP (p<0.001, OR=3.64). Additionally, younger patients (≤45) were found to carry a higher risk for PEP when compared with older patients (≥65) (p=0.023, OR=2.84). In comparison with sphincterotomy, the double-wire technique was associated with a higher risk of complications (p=0.033, OR=2.29).Conclusions We summarised the utilisation and outcomes of ERCP among the Palestinian population in the first advanced centre in Palestine. Cannulation success rates are similar to the established standards and are acceptable compared with other centres worldwide. Perioperative complication rates of ERCP remain infrequent, and death is quite unusual and thus considered a safe procedure.https://bmjopen.bmj.com/content/13/12/e077806.full |
| spellingShingle | HusamEddin Z Salama Yousef A Alnajjar Tarek A Owais Afnan W M Jobran Ruaa Safi Mohammad Bahar Hazem Al-Ashhab Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study BMJ Open |
| title | Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study |
| title_full | Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study |
| title_fullStr | Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study |
| title_full_unstemmed | Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study |
| title_short | Endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in Palestine at Al-Ahli Hospital: a retrospective cohort study |
| title_sort | endoscopic retrograde cholangiopancreatography utilisation and outcomes in the first advanced endoscopy centre in palestine at al ahli hospital a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/13/12/e077806.full |
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