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Safety and efficacy of endoscopic retrograde cholangiopancreatography for common bile duct stones in liver cirrhotic patients

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Summary

In order to investigate the safety and efficacy of endoscopic retrograde cholangiopancreatograpy (ERCP) in liver cirrhosis patients with common bile duct stones, we retrospectively analyzed data of 46 common bile duct stones patients with liver cirrhosis who underwent ERCP between 2000 and 2008. There were 12 cases of Child-Pugh A, 26 cases of Child-Pugh B, and 8 cases of Child-Pugh C. 100 common bile duct stones patients without liver cirrhosis were randomly selected. All the patients were subjected to ERCP for biliary stones extraction. The rates of bile duct clearance and complications were compared between cirrhotic and non-cirrhotic patients. The success rate of selective biliary cannulation was 95.6% in liver cirrhotic patients versus 97% in non-cirrhotic patients (P>0.05). The bile duct clearance rate was 87% in cirrhotic patients versus 96% in non-cirrhotic patients, but the difference was not statistically significant. Two liver cirrhotic patients (4.35%, 2/46) who were scored Child-Pugh C had hematemesis and melena 24 h after ERCP. The hemorrhage rate after ERCP in non-cirrhotic patients was 3%. The hemorrhage rate associated with ERCP in Child-Pugh C patients was significantly higher (25%, 2/8) than that (3%, 3/100) in non-cirrhotic patients (P<0.01%). There was no significant difference between these two groups in the rate of post-ERCP pancreatitis (PEP) and cholangitis. ERCP is safe and effective for Child-Pugh A and B cirrhotic patients with common bile duct stones. Hemorrhage risk in ERCP is higher in Child-Pugh C patients.

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Authors and Affiliations

  1. Department of Gastroenterology, Huazhong University of Science and Technology, Wuhan, 430030, China

    De-min Li  (李德民), Qiu Zhao  (赵 秋), Hua Qin  (覃 华), Bo Wang  (王 波), Rong-xiang Li  (李荣香), Min Zhang  (张 敏), Ji-fen Hu  (胡继芬) & Min Yang  (杨 敏)

  2. Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jie Zhao  (赵 洁)

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  1. De-min Li  (李德民)
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  2. Jie Zhao  (赵 洁)
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  3. Qiu Zhao  (赵 秋)
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  4. Hua Qin  (覃 华)
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  5. Bo Wang  (王 波)
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  6. Rong-xiang Li  (李荣香)
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  7. Min Zhang  (张 敏)
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  8. Ji-fen Hu  (胡继芬)
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  9. Min Yang  (杨 敏)
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Correspondence to Qiu Zhao  (赵 秋).

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Li, Dm., Zhao, J., Zhao, Q. et al. Safety and efficacy of endoscopic retrograde cholangiopancreatography for common bile duct stones in liver cirrhotic patients. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 34, 612–615 (2014). https://doi.org/10.1007/s11596-014-1325-x

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  • DOI: https://doi.org/10.1007/s11596-014-1325-x

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