Antibiotic prophylaxis and post-procedure infectious complications in endoscopic retrograde cholangiopancreatography with peroral cholangioscopy
Gustafsson, Arvid LU
; Enochsson, Lars
; Tingstedt, Bobby
LU
and Olsson, Greger
LU
(2023)
In Endoscopy International Open
11(12).
p.1177-1183
- Abstract
- Background and study aims Single-operator peroral cholangioscopy (SOC) has gained increasing attention in modern biliary and pancreatic therapy and diagnosis. This procedure has shown higher rates of infectious complications than conventional endoscopic retrograde cholangiopancreatography (ERCP); therefore, many guidelines recommend antibiotic prophylaxis (AP). However, whether AP administration decreases infectious or overall adverse events (AEs) has been little studied. We aimed to study whether AP affects post-procedure infectious or overall AEs in ERCP with SOC.
Patients and methods We collected data from the Swedish Registry for Gallstone Surgery and ERCP (GallRiks). Of the 124,921 extracted ERCP procedures performed between... (More) - Background and study aims Single-operator peroral cholangioscopy (SOC) has gained increasing attention in modern biliary and pancreatic therapy and diagnosis. This procedure has shown higher rates of infectious complications than conventional endoscopic retrograde cholangiopancreatography (ERCP); therefore, many guidelines recommend antibiotic prophylaxis (AP). However, whether AP administration decreases infectious or overall adverse events (AEs) has been little studied. We aimed to study whether AP affects post-procedure infectious or overall AEs in ERCP with SOC.
Patients and methods We collected data from the Swedish Registry for Gallstone Surgery and ERCP (GallRiks). Of the 124,921 extracted ERCP procedures performed between 2008 and 2021, 1,605 included SOC and represented the study population. Exclusion criteria were incomplete 30-day follow-up, ongoing antibiotic use, and procedures with unspecified indication. Type and dose of antibiotics were not reported. Post-procedure infectious complications and AEs at 30-day follow-up were the main outcomes.
Results AP was administered to 1,307 patients (81.4%). In this group, 3.4% of the patients had infectious complications compared with 3.7% in the non-AP group. The overall AE rates in the AP and non-AP groups were 14.6% and 15.2%, respectively. The incidence of cholangitis was 3.1% in the AP group and 3.4% in the non-AP group. Using multivariable analysis, both infectious complications (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.54–1.57) and AEs (OR 0.87, 95% CI 0.65–1.16) remained unaffected by AP administration.
Conclusions No reduction in infectious complication rates and AEs was seen with AP administration for SOC. The continued need for AP in SOC remains uncertain (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/b8bf827b-5b59-4d83-9655-96fc5ddb9d6d
- author
- Gustafsson, Arvid
LU
; Enochsson, Lars
; Tingstedt, Bobby
LU
and Olsson, Greger
LU
- organization
- publishing date
- 2023-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Endoscopy International Open
- volume
- 11
- issue
- 12
- pages
- 1177 - 1183
- publisher
- Georg Thieme Verlag
- external identifiers
-
- pmid:38094034
- ISSN
- 2364-3722
- DOI
- 10.1055/a-2210-6283
- language
- English
- LU publication?
- yes
- id
- b8bf827b-5b59-4d83-9655-96fc5ddb9d6d
- date added to LUP
- 2024-09-12 13:13:53
- date last changed
- 2025-04-04 14:11:38
@article{b8bf827b-5b59-4d83-9655-96fc5ddb9d6d,
abstract = {{Background and study aims Single-operator peroral cholangioscopy (SOC) has gained increasing attention in modern biliary and pancreatic therapy and diagnosis. This procedure has shown higher rates of infectious complications than conventional endoscopic retrograde cholangiopancreatography (ERCP); therefore, many guidelines recommend antibiotic prophylaxis (AP). However, whether AP administration decreases infectious or overall adverse events (AEs) has been little studied. We aimed to study whether AP affects post-procedure infectious or overall AEs in ERCP with SOC.<br/><br/>Patients and methods We collected data from the Swedish Registry for Gallstone Surgery and ERCP (GallRiks). Of the 124,921 extracted ERCP procedures performed between 2008 and 2021, 1,605 included SOC and represented the study population. Exclusion criteria were incomplete 30-day follow-up, ongoing antibiotic use, and procedures with unspecified indication. Type and dose of antibiotics were not reported. Post-procedure infectious complications and AEs at 30-day follow-up were the main outcomes.<br/><br/>Results AP was administered to 1,307 patients (81.4%). In this group, 3.4% of the patients had infectious complications compared with 3.7% in the non-AP group. The overall AE rates in the AP and non-AP groups were 14.6% and 15.2%, respectively. The incidence of cholangitis was 3.1% in the AP group and 3.4% in the non-AP group. Using multivariable analysis, both infectious complications (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.54–1.57) and AEs (OR 0.87, 95% CI 0.65–1.16) remained unaffected by AP administration.<br/><br/>Conclusions No reduction in infectious complication rates and AEs was seen with AP administration for SOC. The continued need for AP in SOC remains uncertain}},
author = {{Gustafsson, Arvid and Enochsson, Lars and Tingstedt, Bobby and Olsson, Greger}},
issn = {{2364-3722}},
language = {{eng}},
month = {{12}},
number = {{12}},
pages = {{1177--1183}},
publisher = {{Georg Thieme Verlag}},
series = {{Endoscopy International Open}},
title = {{Antibiotic prophylaxis and post-procedure infectious complications in endoscopic retrograde cholangiopancreatography with peroral cholangioscopy}},
url = {{http://dx.doi.org/10.1055/a-2210-6283}},
doi = {{10.1055/a-2210-6283}},
volume = {{11}},
year = {{2023}},
}