Korean J Gastroenterol.  2014 Apr;63(4):216-222. 10.4166/kjg.2014.63.4.216.

A Single Institution's Experience of Infundibulotomy in Patients Taking Antiplatelet Agents: Outcomes, Safety and Complications

• Baek DH
• Song GA
• Kim DU
• Kim GH
• Lee BE
• Jeon HK
• Jhi JH
• Bae JH
• Lee HJ

• KMID: 1791878
• DOI: http://doi.org/10.4166/kjg.2014.63.4.216

Abstract

BACKGROUND/AIMS
The diagnostic and therapeutic utility of endoscopic retrograde cholangiopancreatography (ERCP) has been well demonstrated for biliary and pancreatic diseases. Biliary access can be allowed by infundibulotomy if failed by using the standard cannulation methods. However, no data are available regarding ERCP-related complications in patients taking antiplatelet agents who are undergoing infundibulotomy. Therefore, we aimed to assess the frequency of ERCP-related complications after infundibulotomy in patients taking antiplatelet agents.
METHODS
We performed a retrospective study, and enrolled 835 patients who underwent ERCP at Pusan National University Hospital from January 2011 to December 2012. Seventy-two patients had been taking antiplatelet agents prior to the procedure. Patients were classified into two groups according to the utilization of infundibulotomy: 20 patients underwent infundibulotomy (group 1), and 52 patients did not undergo infundibulotomy (group 2). Complications after ERCP were defined as bleeding, post-ERCP pancreatitis, and perforation according to Cotton's criteria.
RESULTS
Between group 1 and 2, there were no significant differences in baseline characteristics. ERCP was successfully performed in all cases. Clinically significant bleeding was observed in one patient in group 1 (5%, 1/20) versus none in group 2. Post-ERCP pancreatitis was observed in 2 patients (10.0%, 2/20) in group 1, and 7 patients (13.5%, 7/52) in group 2 (p=0.691). However, none of these differences were statistically significant. No perforation occurred in both groups.
CONCLUSIONS
Considering the low incidence of bleeding after infundibulotomy in patients taking antiplatelet agents, infundibulotomy may be safely performed in this group of patients.

Keyword

Endoscopic retrograde cholangiopancreatography; Antiplatelet agents; Infundibulotomy; Complications

MeSH Terms

Aged
*Cholangiopancreatography, Endoscopic Retrograde/adverse effects
Female
Hemorrhage/etiology
Humans
Male
Middle Aged
Pancreatitis/etiology
Pituitary Gland/*surgery
Platelet Aggregation Inhibitors/administration & dosage/*adverse effects
Retrospective Studies
Sphincterotomy, Endoscopic
Platelet Aggregation Inhibitors

Reference

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