Sadeghi Amir, Hezaveh Ehsan Bahrami, Arabpour Erfan, Tape Parya Mozafari Komesh, Rastegar Reyhaneh, Zali Mohammad Reza
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Indian J Gastroenterol. 2025 Aug;44(4):496-505. doi: 10.1007/s12664-025-01771-x. Epub 2025 May 29.
The potential impact of opium addiction on medical procedures has not been thoroughly investigated. In the present study, we aimed at investigating the potential association between opium addiction and the outcomes of endoscopic retrograde cholangiopancreatography (ERCP).
In this retrospective case-control study, patients who underwent ERCP between July 2021 and October 2023 at a tertiary care center were screened and patients with opium addiction were matched with non-addict patients based on age, sex, ERCP indication and the cannulation approach at 1:1 ratio. The analysis compared the ERCP findings and post-ERCP complications between the two groups.
Overall, 276 patients with and without opium addiction were included (n = 138 for each group). The overall complication rate in the opium group was 10.1%, significantly higher than the control group (1.4%) (p = 0.003). Post-ERCP pancreatitis (5.8% vs. 1.4%, p = 0.046), bleeding (2.9% vs. 0%, p = 0.044) and perforation (1.4% vs. 0%, p = 0.156) were more common in the opium group. The procedural success rate of ERCP was 79.0% in opium group, while patients without opium addiction had a success rate of 85.5%, but it was not statistically significant (p = 0.207).
ERCP could be associated with higher rate of complications in opium-addict patients. Accurate procedural techniques and appropriate prophylaxis should be considered to reduce the risk of complications.
鸦片成瘾对医疗程序的潜在影响尚未得到充分研究。在本研究中，我们旨在调查鸦片成瘾与内镜逆行胰胆管造影术（ERCP）结果之间的潜在关联。
在这项回顾性病例对照研究中，对2021年7月至2023年10月在一家三级医疗中心接受ERCP的患者进行筛选，并根据年龄、性别、ERCP指征和插管方法，将鸦片成瘾患者与非成瘾患者按1:1的比例进行匹配。分析比较了两组之间的ERCP检查结果和ERCP术后并发症。
总体而言，纳入了276例有和没有鸦片成瘾的患者（每组n = 138）。鸦片组的总体并发症发生率为10.1%，显著高于对照组（1.4%）（p = 0.003）。ERCP术后胰腺炎（5.8%对1.4%，p = 0.046）、出血（2.9%对0%，p = 0.044）和穿孔（1.4%对0%，p = 0.156）在鸦片组中更为常见。鸦片组ERCP的操作成功率为79.0%，而无鸦片成瘾的患者成功率为85.5%，但差异无统计学意义（p = 0.207）。
ERCP可能与鸦片成瘾患者的较高并发症发生率相关。应考虑采用精确的操作技术和适当的预防措施以降低并发症风险。
