Mortality after endoscopic retrograde cholangiopancreatography

Abstract

Aim: Endoscopic retrograde cholangiopancreatography is a high quality but invasive procedure performed for diagnosis and treatment of biliary tract, pancreatic tract and periampullary region diseases. Risk factors for complications include known or unsuspected premorbid conditions, problems related to anxiety and insufficient analgesia. Material and Method: We retrospectively reviewed 1471 patients who underwent elective or emergent Endoscopic retrograde cholangiopancreatography with routine monitoring and standard sedoanalgesia protocol between 2011 and 2016. Patients who had specific (surgical) and non-specific (cardiovascular, respiratory) complications during procedure and admitted to ICU were selected. Age, gender, body mass index, ASA class, comordities, duration of procedure, drugs used, complication and therapeutic interventions were assessed in remaining patient who died in ICU. Results: 10 patients had complications during procedure and internalize at ICU. 7 of them (0,47%) had died. In mortal patients, mean CCI score was 3.00±0.81, while mean APACHE II score was 38.71±4.07 and mean expected mortality was 88.22±7.23. Discussion: In conclusion, one should be careful in standard monitoring and patient selection in addition to physical conditions against risk factors that may increase mortality regardless of sedation method used in Endoscopic retrograde cholangiopancreatography. Using APACHE II score and CCI rather than ASA score can be more effective for prediction of mortality.