Preliminary Analysis Of Risk Factors Of Complications After ERCP In Patients With Hepatic Alveolar Echinococcosis

purpose:Alveolar echinococcosis(AE)is an invasive disease that easily invades the intrahepatic biliary tract and veins,resulting in some biliary complications.Endoscopic retrograde cholangiopancreatography(ERCP)is the most important treatment for biliary complications therapeutic intervention.However,the incidence of complications after ERCP in patients with AE remains high in clinical practice.Therefore,the purpose of this study was to retrospectively analyze the risk factors about complications after ERCP in patients with AE.Methods:The study included data from 51 cases with AE who had undergone therapeutic ERCP between January 2015 and December 2019.Procedure-related complications and their respective risk factors were investigated.Results: The incidence rates of pancreatitis,bleeding,cholangitis after ERCP were 9.8%,9.8% and 7.8%,respectively.In univariate analysis,age<30(p=0.012)and difficult intubation(p=0.046)were significant risk factors for PEP.Then hilar bile duct stenosis(p=0.016),endoscopic retrograde biliary drainage(p=0.007),a stent diameter ≥8.5 Fr(p<0.001)and single stent implantation(p=0.010)were risk factors for cholangitis.In addition,elevated hemoglobin(p=0.005)and male patients(p=0.043)were significant risk factors for bleeding.Conclusion: First,the incidence of PEP is related to young patients or difficult intubation during operations.Second,patients with hilar bile duct compression or endoscopic retrograde biliary drainage seem to easily prone to cholangitis,the number and diameter of biliary stents may influence cholangitis.Third,the diagnosis of bleeding should be based on the clinical symptoms(hematemesis and black stool),especially at higher altitude areas,rather than only the decrease of hemoglobin.