Analysis of Risk Factors in Endoscopic Retrograde Cholangiopancreatography-Related Immediate and Delayed Hemorrhage

Abstract

Background/Aims

Hemorrhage is a serious complication of endoscopic retrograde cholangiopancreatography (ERCP). However, there is a lack of comparative studies on immediate and delayed hemorrhage. The present study aims to explore the relevant risk factors of immediate and delayed hemorrhage of ERCP and compare the similarities and differences.

Methods

ERCP cases conducted by our hospital between January 2017 and January 2020 were selected for retrospective analysis. Then age, gender, basic disease, laboratory examinations, and other relevant clinical information were collected for the analysis.

Results

A total of 1009 ERCP cases were included in the present study. Among these cases, 76 patients were in the immediate hemorrhage group, 28 patients were in the delayed hemorrhage group, and 905 patients were in the non-hemorrhage group. The univariate analysis revealed that choledocholithiasis, pre-cut, and endoscopic papillary sphincterotomy (EST) were risk factors for immediate hemorrhage, while cholangitis, jaundice, coronary heart disease, pre-cut, high postoperative lipase at four hours and amylase at 24 h, high postoperative leukocyte, urea, bilirubin, low postoperative platelet counts and fibrinogen, and prolonged prothrombin time (PT) and thrombin time (TT) were risk factors for delayed hemorrhage. The logistic regression analysis revealed that EST, pre-cut, and activated partial thromboplastin time (APTT) were independent risk factors for immediate hemorrhage, while high amylase at 24 h after ERCP, high postoperative urea, prolonged TT, and coronary heart disease were independent risk factors for delayed hemorrhage.

Conclusions

Pre-cut was a common risk factor for immediate and delayed hemorrhage, while other risk factors were different.

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Data availability

The data were collected by checking medical records in the medical management system of Renmin Hospital of Wuhan University. The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare no funding resource in this study.

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Authors

Contributions

XLY, YZ, XYW, and TD were responsible for the preparation and design of the experiment, XLY and YZ were responsible for the collection of data, XYW, XLY, and YZ analyzed the data, TD and XLY jointly completed the final manuscript.

Corresponding author

Correspondence to Tao Deng.

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The authors declare that they have no competing interests.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki declaration and its later amendments. For this type of study, formal consent is not required.

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Ye, X., Zhang, Y., Wan, X. et al. Analysis of Risk Factors in Endoscopic Retrograde Cholangiopancreatography-Related Immediate and Delayed Hemorrhage. Dig Dis Sci (2021). https://doi.org/10.1007/s10620-020-06815-0

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Keywords

  • Endoscopic retrograde cholangiopancreatography
  • Adverse events
  • Immediate hemorrhage
  • Delayed hemorrhage
  • Risk factors