Post-ERCP cholecystitis: Incidence, characteristics, and outcomes from a prospective multicenter biliary endoscopy registry

Rishad Khan; Hana Osman; Sangmin Lee; Yen-I Chen; Andrew Singh; Lawrence Hookey; Naveen Arya; Natalia Causada Calo; Samir C Grover; Alejandra Tepox-Padrón; Sydney Bass; Martin Cole; Yang Lei; Suqing Li; Rachid Mohamed; Christian Turbide; Hannah F Koury; Millie Chau; Megan Howarth; Shane Cartwright; Steven J Heitman; Nauzer Forbes

doi:10.1016/j.gie.2023.12.010

Post-ERCP cholecystitis: Incidence, characteristics, and outcomes from a prospective multicenter biliary endoscopy registry

Gastrointest Endosc. 2024 Apr;99(4):633-640. doi: 10.1016/j.gie.2023.12.010. Epub 2023 Dec 11.

Authors

Rishad Khan¹, Hana Osman², Sangmin Lee², Yen-I Chen³, Andrew Singh⁴, Lawrence Hookey⁵, Naveen Arya⁶, Natalia Causada Calo⁷, Samir C Grover⁸, Alejandra Tepox-Padrón⁹, Sydney Bass⁹, Martin Cole⁹, Yang Lei⁹, Suqing Li⁹, Rachid Mohamed⁹, Christian Turbide⁹, Hannah F Koury⁹, Millie Chau⁹, Megan Howarth⁹, Shane Cartwright⁹, Steven J Heitman¹⁰, Nauzer Forbes¹¹

Affiliations

¹ Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada.
² Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Division of Gastroenterology and Hepatology, McGill University, Montreal, Quebec, Canada.
⁴ Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of British Columbia, Victoria, British Columbia, Canada.
⁵ Division of Gastroenterology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
⁶ Division of Gastroenterology, Oakville Trafalgar Memorial Hospital, Oakville, Ontario, Canada.
⁷ Division of Gastroenterology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
⁸ Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada.
⁹ Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁰ Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹¹ Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: nauzer.forbes@ucalgary.ca.

PMID: 38092126
DOI: 10.1016/j.gie.2023.12.010

Abstract

Background and aims: The incidence, risk factors, and outcomes of post-ERCP cholecystitis are poorly described. We aimed to describe cases of post-ERCP cholecystitis from a prospective multicenter registry with protocolized 30-day follow-up.

Methods: Patient- and procedure-related data from 7 centers were obtained. The primary outcome was post-ERCP cholecystitis, defined according to a Delphi-based criteria and causal attribution system. Risk factors and outcomes were described for all cases.

Results: Seventeen cases of post-ERCP cholecystitis were identified among 4428 patients with gallbladders undergoing ERCP between 2018 and 2023 (incidence, 0.38%; 95% confidence interval, 0.20-0.57). In ERCPs with covered metal stenting, 7 of 467 resulted in cholecystitis (incidence, 1.50%; 95% confidence interval, 0.40-2.60). Patients had symptoms at a median of 5 days (interquartile range, 5) after ERCP. Management strategies included cholecystectomy, percutaneous cholecystostomy, and endoscopic stent removal/exchange.

Conclusions: Estimates of post-ERCP cholecystitis incidence can inform discussions around procedural risk.

MeSH terms

Biliary Tract*
Cholangiopancreatography, Endoscopic Retrograde / adverse effects
Cholecystitis* / epidemiology
Cholecystitis* / etiology
Humans
Incidence
Multicenter Studies as Topic
Prospective Studies
Retrospective Studies