{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:59:31Z","timestamp":1790200771208,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T00:00:00Z","timestamp":1491436800000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and aims\u2002Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database.<\/jats:p><jats:p>\n          Methods\u2002We conducted a matched case\u200a\u2013\u200acontrol study using the 2010 National Inpatient Sample database in which four non-cirrhotic controls were matched randomly for every cirrhotic patient from the same 10-year age group.\u200aWe compared adverse events and safety of inpatient ERCP between patients with (n\u200a=\u200a3228) and without liver cirrhosis (controls, n\u200a=\u200a12 912).<\/jats:p><jats:p>\n          Results\u2002Of the 3228 cirrhotic patients, 2603 (80.6\u200a%) had decompensated and 625 (19.4\u200a%) had compensated disease. Post-procedure bleeding (2.1\u200a% vs. 1.2\u200a%, P\u200a&lt;\u200a0.01) was higher in patients compared to controls. On multivariable analysis, decompensated cirrhosis (adjusted odds ratio [aOR], 2.7; 95\u200a% confidence interval [CI], 2.2\u200a\u2013\u200a3.2), compensated cirrhosis (aOR 2.2; 95\u200a%CI 1.2\u200a\u2013\u200a3.9), therapeutic ERCPs (aOR 1.4; 95\u200a% CI 1.2\u200a\u2013\u200a2.1), and biliary sphincterotomy (aOR 1.6; 95\u200a%CI 1.1\u200a\u2013\u200a2.1) were independently associated with increased risk of post-procedure bleeding. Performing ERCPs in large (aOR 0.5; 95\u200a%CI 0.4\u200a\u2013\u200a0.6) and medium (aOR 0.7; 95\u200a%CI 0.6\u200a\u2013\u200a0.9) sized hospitals was associated with a decreased risk of post-procedure bleeding. Biliary sphincterotomy (aOR 1.7; 95\u200a%CI 1.2\u200a\u2013\u200a2.3) and therapeutic ERCPs (aOR 1.1; 95\u200a%CI 1.1\u200a\u2013\u200a1.3) increased the risk of post-ERCP pancreatitis, and pancreatic stent placement was associated with a decreased risk of post-ERCP pancreatitis (aOR 0.8; 95\u200a%CI 0.7\u200a\u2013\u200a0.9).<\/jats:p><jats:p>\n          Conclusions\u2002Cirrhosis (both compensated and decompensated), performing therapeutic ERCPs and biliary sphincterotomy increase the risk of post-procedure bleeding. Performing ERCPs in large and medium sized hospitals may improve outcomes.<\/jats:p>","DOI":"10.1055\/s-0043-102492","type":"journal-article","created":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T22:47:02Z","timestamp":1491518822000},"page":"E303-E314","source":"Crossref","is-referenced-by-count":36,"title":["Safety of ERCP in patients with liver cirrhosis: a national database study"],"prefix":"10.1055","volume":"05","author":[{"given":"Udayakumar","family":"Navaneethan","sequence":"additional","affiliation":[{"name":"Center for Interventional Endoscopy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basile","family":"Njei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Yale University, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center for Interventional Endoscopy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Kommaraju","sequence":"additional","affiliation":[{"name":"Center for Interventional Endoscopy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour","family":"Parsi","sequence":"additional","affiliation":[{"name":"The Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyam","family":"Varadarajulu","sequence":"additional","affiliation":[{"name":"Center for Interventional Endoscopy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,4,6]]},"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-102492.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T14:35:03Z","timestamp":1557153303000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-102492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2017,3,22]]},"published-print":{"date-parts":[[2017,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-102492","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4]]}}}