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Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Acute Coronary Syndrome
Gut and Liver ; : 674-679, 2014.
Article in English | WPRIM | ID: wpr-37646
ABSTRACT
BACKGROUND/

AIMS:

Endoscopic retrograde cholangiopancreatography (ERCP) is considered a high-risk procedure in patients with previous acute coronary syndrome (ACS); however, clinical studies are rare in the literature. The aim of this study was to investigate the safety and efficacy of ERCP in patients with previous ACS.

METHODS:

We retrospectively reviewed the medical records of patients with previous ACS who underwent ERCP between January 2007 and August 2012. The clinical characteristics, ERCP diagnoses, treatment results, and complications were analyzed.

RESULTS:

Fifty patients underwent ERCP an average of 41.6 months after ACS. The most common indication for ERCP was calculous cholangitis. After deep biliary cannulation, endoscopic sphincterotomy, biliary stone removal and endoscopic biliary drainage were successfully performed. Immediate postsphincterotomy bleeding occurred in seven patients, which was successfully controlled using endoscopic therapy. Elevation of cardiac troponin I levels were observed in three patients (6%) before ERCP, and all of these patients were diagnosed with pancreatobiliary disease combined with recurrent ACS, which was treated with coronary artery stent insertion (n=2) and balloon angioplasty (n=1).

CONCLUSIONS:

Therapeutic ERCP is effective and safe in patients with previous ACS. Cardiac troponin I elevation should be considered a warning sign for recurrent ACS in patients who undergo ERCP.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Recurrence / Ampulla of Vater / Carcinoma / Cholelithiasis / Angioplasty, Balloon, Coronary / Stents / Drainage / Cholangitis / Retrospective Studies / Cholangiopancreatography, Endoscopic Retrograde Type of study: Etiology study / Observational study / Risk factors Limits: Aged / Aged80 / Female / Humans / Male Language: English Journal: Gut and Liver Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Recurrence / Ampulla of Vater / Carcinoma / Cholelithiasis / Angioplasty, Balloon, Coronary / Stents / Drainage / Cholangitis / Retrospective Studies / Cholangiopancreatography, Endoscopic Retrograde Type of study: Etiology study / Observational study / Risk factors Limits: Aged / Aged80 / Female / Humans / Male Language: English Journal: Gut and Liver Year: 2014 Type: Article