2017- 2022 yılları arasında ERCP yapılan hastalarda gelişen komplikasyonların retrospektif incelenmesi
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Date
2023
Authors
Altınkaynak, Ece
Journal Title
Journal ISSN
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Publisher
Bursa Uludağ Üniversitesi
Abstract
Endoskopik retrograd kolanjiopankreatografi (ERCP); safra yolları ve pankreas hastalıklarının tanı ve tedavisinde kullanılan invaziv bir yöntemdir. ERCP’nin en sık görülen komplikasyonları; pankreatit, kanama, kolanjit, kolesistit ve perforasyondur. Çalışmamızda 01.12.2017-01.12.2022 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi iç hastalıkları anabilim dalı gastroenteroloji bölümünde ERCP yapılan ve komplikasyon gelişen hastaların demografik özelliklerinin, ERCP bulgularının, ERCP esnasında gerçekleştirilen müdahalelerin, işleme bağlı komplikasyonların, ERCP esnasında gerçekleştirilen müdahaleler ile komplikasyonlar arasındaki ilişkilerin ve tedavi sonrası klinik durumlarının retrospektif olarak incelenmesi ve değerlendirilmesi amaçlanmıştır. Çalışmaya alınan hastaların bilgilerine hastanemiz bilgi sistemi dijital ortamından retrospektif olarak ulaşılmıştır.5 yıllık süreçte 1934 ERCP işlemi yapılmıştır. 150 hastada işlem sonrası karın ağrısı şikayeti gelişmiştir. 102(%5,2) hastada komplikasyon tespit edilmiştir. Hastaların 58’inde (%2,9) pankreatit, 29’unda (%1,4) kolanjit,7’sinde (%0,36) kanama, 8’inde (%0,41) perforasyon, 6’sında (%0,31) kolesistit, 4’ünde (%0,2) apse gelişmiştir. ERCP yapılan hastaların 5’i (%0,25) exitus olmuştur. Hastaların 2’sipankreatit, 2‘si kolanjit, 1‘i pankreatit ve apse nedeniyle exitus olmuştur. Komplikasyon gelişen hastaların 70’i kadın, 32’si erkektir. Yaş ortalamaları 56,9±15,7’dir. Kanama gelişmesi ile yaş arasında istatistik olarak anlamlı bir ilişki gözlenmiştir (p=0,045). Kanama gelişen hastaların çoğunluğunun ≥65 yaş olduğu görülmüştür. Pankreatik kanala guide wire kaçışı ile komplikasyonlar arasında istatistiksel olarak anlamlı farklılık saptanmıştır (p=0,032). Pankreatik kanala guide wire kaçışı olan hastaların 22’sinde (%81,5) pankreatit geliştiği tespit edilmiştir. Hastalarımızın komorbitelerinin, kullandığı ilaçların ve metabolik risk faktörlerinin araştırılmaması ve çalışmamızın retrospektif olması çalışmamız için kısıtlılık oluşturmaktadır. Hasta risk faktörleri incelenerek, prospektif bir çalışma yapılmasının daha güvenilir sonuçlar elde edilmesine katkı sağlayacağını düşünmekteyiz.
Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure used for the diagnosis and treatment of biliary and pancreatic diseases. The most common complications of ERCP include pancreatitis, bleeding, cholangitis, cholecystitis, and perforation. The aim of our study was to retrospectively examine and evaluate the demographic characteristics of patients who underwent ERCP and developed complications, ERCP findings, interventions performed during the procedure, procedure-related complications, the relationship between interventions performed during ERCP and complications, and post-treatment clinical outcomes in the Department of Gastroenterology, Division of Internal Medicine, Uludağ University Medical Faculty between December 1, 2017, and December 1, 2022. The information of the included patients was retrieved retrospectively from the hospital information system in digital format. During a five-year period, a total of 1934 ERCP procedures were performed. Post-procedure abdominal pain was reported in 150 patients. Complications were detected in 102 patients (5.2%). Among them, 58 patients (2.9%) developed pancreatitis, 29 patients (1.4%) developed cholangitis, 7 patients (0.36%) experienced bleeding, 8 patients (0.41%) had perforation, 6 patients (0.31%) developed cholecystitis, and 4 patients (0.2%) had abscess formation. Among the patients who underwent ERCP, 5 (0.25%) died. Two patients died due to pancreatitis, two due to cholangitis, one due to pancreatitis and abscess. Of the patients who developed complications, 70 were female and 32 were male. The mean age was 56.9±15.7. There was a statistically significant relationship between the development of bleeding ixatüreix (p=0.045). The majority of patients who experienced bleeding were ≥65 years old. Statistically significant differences were observed between complications and the escape of guide wire into the pancreatic duct (p=0.032). It was determined that 22 patients (81.5%) who experienced guide wire escape into the pancreatic duct developed pancreatitis. The limitations of our study include the lack of investigation into patients’ comorbidities, medication use, and metabolic risk factors, as well as the retrospective ixatüre of the study. We believe that conducting a prospective study by examining patient risk factors would contribute to obtaining more reliable results.
Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure used for the diagnosis and treatment of biliary and pancreatic diseases. The most common complications of ERCP include pancreatitis, bleeding, cholangitis, cholecystitis, and perforation. The aim of our study was to retrospectively examine and evaluate the demographic characteristics of patients who underwent ERCP and developed complications, ERCP findings, interventions performed during the procedure, procedure-related complications, the relationship between interventions performed during ERCP and complications, and post-treatment clinical outcomes in the Department of Gastroenterology, Division of Internal Medicine, Uludağ University Medical Faculty between December 1, 2017, and December 1, 2022. The information of the included patients was retrieved retrospectively from the hospital information system in digital format. During a five-year period, a total of 1934 ERCP procedures were performed. Post-procedure abdominal pain was reported in 150 patients. Complications were detected in 102 patients (5.2%). Among them, 58 patients (2.9%) developed pancreatitis, 29 patients (1.4%) developed cholangitis, 7 patients (0.36%) experienced bleeding, 8 patients (0.41%) had perforation, 6 patients (0.31%) developed cholecystitis, and 4 patients (0.2%) had abscess formation. Among the patients who underwent ERCP, 5 (0.25%) died. Two patients died due to pancreatitis, two due to cholangitis, one due to pancreatitis and abscess. Of the patients who developed complications, 70 were female and 32 were male. The mean age was 56.9±15.7. There was a statistically significant relationship between the development of bleeding ixatüreix (p=0.045). The majority of patients who experienced bleeding were ≥65 years old. Statistically significant differences were observed between complications and the escape of guide wire into the pancreatic duct (p=0.032). It was determined that 22 patients (81.5%) who experienced guide wire escape into the pancreatic duct developed pancreatitis. The limitations of our study include the lack of investigation into patients’ comorbidities, medication use, and metabolic risk factors, as well as the retrospective ixatüre of the study. We believe that conducting a prospective study by examining patient risk factors would contribute to obtaining more reliable results.
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Keywords
ERCP, ERCP sonrası komplikasyonlar, ERCP sonrası pankreatit, Post-ERCP complications, Post-ERCP pancreatitis
Citation
Altınkaynak, E. (2023). 2017- 2022 yılları arasında ERCP yapılan hastalarda gelişen komplikasyonların retrospektif incelenmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.