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Outcomes of endoscopic retrograde cholangiopancreatography in patients with inflammatory bowel disease: a nationwide study

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Abstract

Purpose

Endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly utilized procedure for both diagnostic and therapeutic purposes. There is a paucity of data for patients with inflammatory bowel disease (IBD) who undergo ERCP. The aim of this study is to examine the indications, complications, and inpatient outcomes of patients with IBD undergoing ERCP.

Methods

For this retrospective cohort study, we utilized the National Inpatient Sample database for the years 2018–2019. We compared potential indications, outcomes, ERCP-related procedures, and resource utilization in patients who underwent ERCP and had a diagnosis of IBD to that of patients who underwent ERCP without a diagnosis of IBD. We utilized a multivariate regression model that accounted for several potential confounders.

Results

We identified 318,590 ERCP procedures. Among them, 3625 ERCP procedures were performed in patients with an associated diagnosis of IBD. Patients with IBD who underwent ERCP had higher odds of acute kidney injury (aOR 1.27; 95% CI: 1.01–1.60) and sepsis (aOR 1.33; 95% CI: 1.07–1.67) compared to patients without IBD. However, inpatient mortality and other complications were not statistically different between the two groups. Patients with IBD were also less likely to undergo biliary sphincterotomy (aOR 0.75; 95% CI: 0.62–0.88) but there were no other differences in performance of ERCP-related therapeutic interventions between the two groups. Adjusted costs and charges were not statistically different between the two groups.

Conclusion

Our study shows that ERCP is, overall, a safe procedure in patients with IBD, as inpatient morbidity and mortality are similar to patients without IBD.

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Data Availability

The data used in this study was obtained from the National Inpatient Sample (NIS) database. The NIS is a publicly available database maintained by the Agency for Healthcare Research and Quality (AHRQ) and contains a representative sample of hospital inpatient stays in the United States. The data used in this study is limited to the years 2018-2019 and is available for download from the AHRQ website.

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Author notes

    Authors and Affiliations

    1. Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA

      Markos Kalligeros

    2. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA

      Paul T. Kröner

    3. Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA

      Francis A. Farraye

    4. Center for Digestive Wellness, University of Massachusetts Chan Medical School, Worcester, MA, USA

      Athanasios Desalermos

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    Contributions

    Conceptualization: Markos Kalligeros, Paul T. Kröner, Athanasios Desalermos; methodology: Markos Kalligeros, Paul T. Kröner; formal analysis: Paul T. Kröner; investigation: Markos Kalligeros, Paul T. Kröner, Athanasios Desalermos; writing—original draft preparation: Markos Kalligeros, Athanasios Desalermos; writing—review and editing: Markos Kalligeros, Paul T. Kröner, Francis A Farraye, Athanasios Desalermos; supervision: Francis A Farraye, Athanasios Desalermos. All authors have read and agreed to the submitted version of the manuscript.

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    Correspondence to Athanasios Desalermos.

    Ethics declarations

    Ethical considerations

    None. This study was retrospective review of publicly available database. No IRB approval or patient consent were obtained.

    Conflict of interest

    M.K., P.T.K., and A.D. declare that they have no potential conflict of interest. F.A.F. is a consultant for BMS, Braintree labs, GSK, Innovation Pharmaceuticals, Iterative Scopes, Janssen, Pfizer, and Sebela and sits on a DSMB for Lilly and Theravance. 

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    Markos Kalligeros and Paul T Kroner contributed equally to this work.

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    Kalligeros, M., Kröner, P.T., Farraye, F.A. et al. Outcomes of endoscopic retrograde cholangiopancreatography in patients with inflammatory bowel disease: a nationwide study. Int J Colorectal Dis 38, 23 (2023). https://doi.org/10.1007/s00384-023-04308-w

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