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

Tsujung Yang; Achint Patel; Rishita Pujari; Vincent Okine; Lakshmi Chirumamilla; Geethu Jnaneswaran; Athul Raj; Keji Kwajok; Ruchir Goswami; Prakashkumar Maiyani; Maheshkumar Desai; Hardikkumar Shah; Matthew Grossman

doi:10.5114/ceh.2022.119246

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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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

MultiCare Good Samaritan Hospital, Puyallup, WA, United States
HCA Healthcare/USF Morsani College of Medicine GME/Oak Hill Hospital, United States
K.J. Somaiya Medical College, India
University of Nebraska Medical Center, Nebraska Medicine, Omaha, United States
DR. N.T.R University of Health Sciences, India
S.U.T Academy of Medical Sciences, Kerala, India
Karuna Institute of Medical Sciences, India
I.M. Sechenov First Moscow State Medical University Moscow, Russia
Icahn School of Medicine at Mount Sinai, New York, NY, United States
Gold Coast University Hospital, Southport, Qld, Australia
Hamilton Medical Center, Medical College of Georgia/Augusta University, Dalton, GA, United States
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:

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

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