ERCP among Cirrhotics: What are the differences?

Emara, Mohamed H; Elbatee, Hassan E; Radwan, Mohamed I; Amer, Ibrahim F; Zaghloul, Mariam S; Ahmed, Mohamed H; Mahrous, Aya M; Elhawari, Soha A; Elshenawy, Eslam M

doi:10.21608/aeji.2020.35918.1096

ERCP among Cirrhotics: What are the differences?

Document Type : Review article and meta analysis

Authors

¹ Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.

² Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

10.21608/aeji.2020.35918.1096

Abstract

The endoscopic retrograde cholangio-pancreatography (ERCP) is considered a main therapeutic intervention in the management of biliary and pancreatic disorders. In the average risk populations it is associated with adverse events. The most common adverse event is post-ERCP pancreatitis. Patients with liver cirrhosis are increasingly seen in ERCP theaters with different indications for the ERCP. Because cirrhotic patients are prone to complications it is expected that they develop more adverse events when operated with ERCP. Bleeding diathesis is the most serious because of the underlying coagulopathy and thrombocytopenia that are commonly encountered among them in particular with advanced Child class. In this mini review we discussed how different is the ERCP among cirrhotics regarding the expected benefits and the reported risks and we showed our experience in dealing with this subgroup of patients. The art of managing cirrhotic patients with ERCP is a team work and not a one man show.

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