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ISSN: 2392-1099
Clinical and Experimental Hepatology
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3/2022
vol. 8
 
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abstract:
Original paper

Outcomes of endoscopic retrograde cholangio-pancreatography in patients with liver transplant

Tsujung Yang
1
,
Achint Patel
2
,
Rishita Pujari
3
,
Vincent P. Okine
4
,
Lakshmi G. Chirumamilla
5
,
Geethu Jnaneswaran
6
,
Athul Raj
7
,
Keji L. Kwajok
8
,
Ruchir Goswami
9
,
Prakashkumar Maiyani
10
,
Maheshkumar Desai
11
,
Hardikkumar Shah
12
,
Matthew Grossman
12

1.
MultiCare Good Samaritan Hospital, Puyallup, WA, United States
2.
HCA Healthcare/USF Morsani College of Medicine GME/Oak Hill Hospital, United States
3.
K.J. Somaiya Medical College, India
4.
University of Nebraska Medical Center, Nebraska Medicine, Omaha, United States
5.
DR. N.T.R University of Health Sciences, India
6.
S.U.T Academy of Medical Sciences, Kerala, India
7.
Karuna Institute of Medical Sciences, India
8.
I.M. Sechenov First Moscow State Medical University Moscow, Russia
9.
Icahn School of Medicine at Mount Sinai, New York, NY, United States
10.
Gold Coast University Hospital, Southport, Qld, Australia
11.
Hamilton Medical Center, Medical College of Georgia/Augusta University, Dalton, GA, United States
12.
St. Joseph Medical Center, Wayne, NJ, United States
Clin Exp HEPATOL 2022; 8, 3: 226-232
DOI: https://doi.org/10.5114/ceh.2022.119246
Online publish date: 2022/09/14
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Aim of the study
Biliary complications are the leading causes of morbidity and mortality after liver transplant (LT). However, national data on endoscopic retrograde cholangiopancreatography (ERCP) usage and outcomes in LT patients are lacking. Our study aims to identify the trends, outcomes, and predictors of ERCP and related complications in this patient subgroup.

Material and methods
We derived our study cohort from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) between 2007 and 2017. LT patients were identified using ICD-9/10-CM diagnosis codes and patients who underwent ERCP were identified by ICD-9/10-CM procedure codes. We utilized the Cochrane-Armitage trend test and multivariate logistic regression to analyze temporal trends, outcomes, and predictors.

Results
A total of 372,814 hospitalizations occurred in LT patients between 2007 and 2017. ERCP was performed in 2.05% (n = 7632) of all hospitalizations. There was a rise in ERCP procedures from 1.96% (n = 477) in 2007 to 2.05% (n = 845) in 2017. Among LT patients who underwent ERCP, the in-hospital mortality rate was 1% (n = 73) and 8% (n = 607) were discharged to facilities. Mean length of hospital stay was 7 ±0.3 days. Septicemia was the most common periprocedural complication (18.3%, n = 1399) followed by post-ERCP pancreatitis (8.8%, n = 674).

Conclusions
There has been an increase in ERCP procedures over the past decade among LT patients. Our study highlights the periprocedural complications and outcomes of ERCP in LT patients from a nationally representative dataset.

keywords:

trends, predictors, outcomes, liver transplant, endoscopic retrograde cholangiopancreatography
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