단일기관에서의 항혈소판제 복용 환자에서 누두절개술의 경험: 결과, 안정성 및 합병증

• Published in: The Korean journal of gastroenterology Vol. 63; no. 4; pp. 216 - 222
• Main Authors: 백동훈, Dong Hoon Baek, 송근암, Geun Am Song, 김동욱, Dong Uk Kim, 김광하, Gwang Ha Kim, 이봉은, Bong Eun Lee, 전혜경, Hye Kyung Jeon, 지준형, Joon Hyung Jhi, 배정호, Jung Ho Bae, 이현정, Hyun Jeong Lee
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30-04-2014
• Subjects: Antiplatelet agents; Complications; Endoscopic retrograde cholangiopancreatography; Infundibulotomy; 내과학
• ISSN: 1598-9992; 2233-6869

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.