Postoperative morbidity by endoscopic retrograde cholangiography with or without ulterior papillotomy. Series of cases.

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Julio Figueroa; Carlos Manterola; Eric Castillo; Camila Figueroa; Renato Carrasco & John Bohle

Summary

Bileduct stones is prevalent in our country, with prevalences between 30% and 50%; and obstructive jaundice secondary to choledocholithiasis (OJC), is a frequent reason of consultation in emergency services. Furthermore, endoscopic papillotomy (EP) post ERCP is the treatment of choice in these cases; however, it is not free of complications (POM). The aim of this study is to describe POM and identify potential risk factors (RF) associated with POM in patients with OJC, underwent PE. Retrospective case series of patients with OJC, who underwent ERCP and subsequent PE. Outcome variable was the development of POM (bleeding, perforation, and pancreatitis). Other variables of interest were cannulation, difficulty of this, developing PE, using precut and mortality. Data collection was performed by an ad-hoc pattern in which the variables extracted from surgical protocols and clinical data were recorded. Descriptive and analytical statistics (Pearson Chi2 and Fisher’s exact test) were applied to assess strength of association. 200 patients were operated. The mean age was 60±18 years; 62% were women (n = 124). MPO was recorded in 32 cases (16.0%): perforation (0.5%), pancreatitis (2.0%) and bleeding (13.5%). The series does not record mortality. It was not possible to objectify association between "difficult cannulation" and the variables bleeding (p= 0.214); pancreatitis (p= 0.519); and perforation (p= 1). However, association between bleeding and performing PE (p= 0.017) was observed. Hemorrhage is the most common cause of MPO in this series; and PE is a RF for the development of bleeding.

KEY WORDS: Choledocholithiasis; Choledocholithiasis/surgery; Gallstones; Bile duct diseases; Cholangiopancreatography; Retrograde cholangiopancreatography; Endoscopic retrograde/therapeutic use.

How to cite this article

FIGUEROA, J.; MANTEROLA, C.; CASTILLO, E.; FIGUEROA, C.; CARRASCO, R. & BOHLE, J. Postoperative morbidity by endoscopic retrograde cholangiography with or without ulterior papillotomy. Series of cases. Int. J. Morphol., 33(2):566-570, 2015.