Turkish Journal of Gastroenterology
Gastrointestinal Endoscopy - Original Article

Clinical outcome of endoscopic retrograde cholangiopancreatography for choledocholithiasis in end-stage renal disease patients on hemodialysis

1.

Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea

2.

Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea

3.

Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea

4.

Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

5.

Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea

6.

Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea

7.

Department of Internal Medicine, Ajou University School of Medicine, Suwon, South Korea

Turk J Gastroenterol 2020; 31: 538-546
DOI: 10.5152/tjg.2020.19521
Read: 873 Downloads: 485 Published: 30 April 2020

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is used as a curative method for choledocholithiasis, but little is known about ERCP for patients with end-stage renal disease (ESRD) on hemodialysis (HD). The aim of the current study was to evaluate the efficacy and safety of ERCP for patients with ESRD on HD and to identify the risk factors of ERCP-related bleeding.

Materials and Methods: The medical records of 61 ESRD patients with choledocholithiasis who underwent ERCP were retrospectively investigated with respect to successful bile duct stone removal and procedure-related adverse events such as pancreatitis, bleeding, and cholangitis.

Results: For the study subjects, the overall stone removal success rate was 96.7%, and the overall ERCP-related adverse event rate was 21.3% (pancreatitis, 4.9%; bleeding, 13.1%; cholangitis, 6.6%). Endoscopic sphincterotomy (EST) was found to be associated with hemorrhage (p=0.02), and the occurrence of hemorrhage in patients who underwent EST with or without endoscopic papillary balloon dilation (EPBD) was significantly higher than that in patients who underwent EPBD alone (Odds ratio 1.27, 95% confidence interval 1.075-1.493, p=0.02).

Conclusion: ERCP for ESRD patients was found to be feasible and safe. However, EST was significantly related to hemorrhagic events. EPBD reduced the risk of hemorrhage and was as effective as EST in terms of stone removal.

Cite this article as: Park JS, Jeong S, Cho JH, et al. Clinical outcome of endoscopic retrograde cholangiopancreatography for choledocholithiasis in end-stage renal disease patients on hemodialysis. Turk J Gastroenterol 2020; 31(7): 538-46.

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