The risk of acute cholangitis after endoscopic stenting for malignant hilar strictures: A large comprehensive study

Background and Aim Endoscopic stenting for unresectable malignant hilar biliary strictures (MHBS) remains challenging. Post‐endoscopic retrograde cholangiopancreatography cholangitis (PEC) can be the most common and fatal adverse event. In the present study, we aimed to systematically evaluate the i...

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Published in:Journal of gastroenterology and hepatology 2020-07, Vol.35 (7), p.1150-1157
Main Authors: Xia, Ming‐Xing, Wang, Shu‐Ping, Wu, Jun, Gao, Dao‐Jian, Ye, Xin, Wang, Tian‐Tian, Zhao, Yi, Hu, Bing
Format: Article
Language:English
Subjects:
acute cholangitis
adverse event
bile duct neoplasms
Cholangitis
endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopy
Implants
Medical prognosis
Risk factors
stent
Stricture
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Summary:Background and Aim Endoscopic stenting for unresectable malignant hilar biliary strictures (MHBS) remains challenging. Post‐endoscopic retrograde cholangiopancreatography cholangitis (PEC) can be the most common and fatal adverse event. In the present study, we aimed to systematically evaluate the incidence, severity, risk factors, and consequences of PEC after endoscopic procedures for advanced MHBS. Methods Of 924 patients, we identified 502 patients with MHBS (Bismuth types II to IV) who underwent endoscopic stenting as the primary therapy at two centers over 16 years. PEC and its severity were verified according to the current Tokyo guidelines. Results A total of 108 patients (21.5%) experienced acute PEC. Mild, moderate, and severe cholangitis were encountered in 51 (10.1%), 42 (8.4%), and 15 (3.0%) patients, respectively. Multivariate analyses showed that metal stenting (verse plastic stenting) (OR 0.328, 95% CI 0.200–0.535, P 
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.14954