GI/Endoscopy Unit, Institut de Malalties Digestives i Metaboliques, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Gastrointest Endosc. 2011 Aug;74(2):285-94. doi: 10.1016/j.gie.2011.04.025. Epub 2011 Jun 25.
Complications of the biliary tract after liver transplantation are successfully managed with ERCP; however, the incidence and risk factors for post-ERCP complications remain unknown.
To examine the incidence, risk factors, and short-term outcome of post-ERCP complications in liver transplant (LT) recipients.
Retrospective evaluation of all ERCPs performed in LT recipients at our institution during a 7-year, 4-month period.
Tertiary referral center.
A total of 243 ERCPs performed in 121 LT recipients with duct-to-duct anastomosis.
Incidence of post-ERCP complications. Predictive factors were determined by univariate and multivariate analyses.
Overall complications occurred in 22 procedures (9%) (13 mild, 9 moderate): pancreatitis in 9 patients (3.7%), cholangitis in 8 patients (3.3%), postsphincterotomy bleeding in 4 patients (1.6%), and subcapsular hematoma in 1 patient (0.4%). The mean hospitalization for post-ERCP complications was 4.8 days (range 2-11 days). Logistic regression identified mammalian target of rapamycin inhibitors (odds ratio [OR], 4.65; 95% CI, 1.01-21.81; P = .049), serum creatinine level greater than 2 mg/dL (OR, 4.17; 95% CI, 1.07-16.26; P = .04), biliary sphincterotomy (OR, 3.03; 95% CI, 1.07-8.53; P = .037), and more than 2 pancreatic duct contrast injections (OR, 2.95; 95% CI, 1.10-7.91; P = .032) as independent risk factors for post-ERCP complications, whereas steroid therapy (OR, 0.23; 95% CI, 0.08-0.63; P = .004) was an independent protective factor.
Single-center retrospective study.
The rate of complications after ERCP in LT recipients seems to be similar to that of non-LT recipients. Complications in this analysis were more common in LT recipients receiving mammalian target of rapamycin inhibitors and those with renal failure, biliary sphincterotomy, and more than 2 pancreatic duct injections, whereas they were less common in those patients on steroid therapy.
经内镜逆行胰胆管造影术（ERCP）可成功治疗肝移植术后胆道并发症；然而，术后 ERCP 并发症的发生率和危险因素仍不清楚。
研究肝移植（LT）受者行 ERCP 后的并发症发生率、危险因素和短期预后。
对本机构在 7 年 4 个月期间进行的所有 LT 受者 ERCP 的回顾性评估。
三级转诊中心。
121 例 LT 受者共行 243 例 ERCP，均为胆管对胆管吻合术。
术后 ERCP 并发症的发生率。通过单因素和多因素分析确定预测因素。
共有 22 例（9%）（轻度 13 例，中度 9 例）发生术后并发症：9 例（3.7%）发生胰腺炎，8 例（3.3%）发生胆管炎，4 例（1.6%）发生括约肌切开术后出血，1 例（0.4%）发生肝包膜下血肿。术后 ERCP 并发症的平均住院时间为 4.8 天（范围 2-11 天）。Logistic 回归分析确定雷帕霉素靶蛋白抑制剂（比值比 [OR]，4.65；95%置信区间 [CI]，1.01-21.81；P =.049）、血清肌酐水平大于 2mg/dL（OR，4.17；95%CI，1.07-16.26；P =.04）、胆管括约肌切开术（OR，3.03；95%CI，1.07-8.53；P =.037）和胰管对比剂注射超过 2 次（OR，2.95；95%CI，1.10-7.91；P =.032）为术后 ERCP 并发症的独立危险因素，而激素治疗（OR，0.23；95%CI，0.08-0.63；P =.004）是独立保护因素。
单中心回顾性研究。
LT 受者 ERCP 后并发症的发生率似乎与非 LT 受者相似。在本分析中，接受雷帕霉素靶蛋白抑制剂治疗和患有肾衰竭、胆管括约肌切开术以及胰管注射超过 2 次的 LT 受者更常见并发症，而接受激素治疗的患者则较少发生并发症。
