Research Article

ERCP-Related Adverse Events in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

Table 2

Characteristics of included studies and patients.

Study designNumber of patientsNumber of ERCPsAge (years)Male n (%)PSC characteristicsRelevant comorbidities

Adler (2016)Retrospective cohortPSC: 376
Non-PSC: 162
Cirrhosis: 376 (100%)
Alkhatib (2011)Retrospective cohortPSC: 75PSC: 185Mean 50.1 (range 15–85)58 (77%)Cirrhosis: 6 (8%)Autoimmune hepatitis: 2 (3%)
IBD: 42 (55%)
Baluyut (2001)Retrospective cohort63Mean 46.7 ± 15.838 (60%)Baseline cholangitis: 31 (49%)
Dominant stricture: 63 (100%)
Bangarulingam (2009)Retrospective cohortPSC: 168
Non-PSC: 981
PSC: 308
Non-PSC: 1268
PSC mean: 48 ± 15
Non-PSC mean: 60 ± 19
PSC: 111 (66.1%)
Non-PSC: 440 (44.9%)
Portal hypertension: 53 (32%)
Cazzagon (2019)Retrospective cohortPSC: 31PSC: 63Median: 36 (27–52)20 (65%)Baseline cholangitis: 5 (16%)
Cirrhosis: 10 (32%)
Dominant stricture: 31 (100%)
Enns (2003)Retrospective cohortPSC: 104PSC: 204Mean 45 ± 13.666 (63%)Dominant stricture: 69 (66%)IBD: 94 (53%)
Etzel (2008)Retrospective cohortPSC: 30
Non-PSC: 45
PSC: 85
Non-PSC: 70
PSC mean: 44.5 ± 2.1 (range 24–69)
Non-PSC mean: 56.5 ± 2.4 (range 28–85)
PSC: 22 (73.3%)
Non-PSC: 28 (62.2%)
Dominant stricture: 63 (76%)
Mean duration of PSC: 4.55 years (range 0–15)
Gluck (2008)Retrospective cohortPSC: 106PSC: 317Mean: 47 (range 15–86)65 (61%)Cirrhosis: 41 (39%)Cholangiocarcinoma: 13 (12%)
IBD: 86 (74%)
Liver transplant: 7 (7%)
Gotthardt (2010)Prospective cohortPSC: 96PSC: 500Mean: 37.4 ± 1.4 (range 17–77)69 (71.9%)Dominant stricture: 97 (100%)Cholangiocarcinoma: 6 (6%)
Liver transplant: 22 (23%)
Ismail (2012)Retrospective cohortPSC: 441Median: 38 (range 5–80)238 (54%)Prior biliary sphincterotomy: 147 (38%)
Kaya (2001)Retrospective cohortBalloon dilation: 34
Balloon dilation and stenting: 14
Balloon dilation: 73
Balloon dilation and stenting: 80
Balloon dilation median: 50.5 (range 21–72)
Balloon dilation and stenting median: 44 (range 18–78)
Balloon dilation: 22 (64.7%)
Balloon dilation and stenting: 18 (48.6%)
Dominant stricture: 71 (100%)IBD: 45 (63%)
Koskensalo (2020)Retrospective case-controlDiclofenac: 378
No diclofenac: 553
Diclofenac: 1000
No diclofenac: 1000
Diclofenac median: 40 (range 16–73)
No diclofenac median: 39 (16–79)
Diclofenac: 238 (63%)
No diclofenac: 327 (59.1%)
Navaneethan (2015)Retrospective cohortPSC: 294PSC: 657Median: 47 (range 12–85)203 (69%)Prior biliary sphincterotomy: 64 (21.8%)
Navaneethan (2017)Prospective cohort with the historical control groupGroup 1 (control): 156
Group 2 (bile aspiration before contrast injection): 46
Group 1: 156
Group 2: 46
Group 1 mean: 43.77 ± 18.9
Group 2 mean: 54.96 ± 15.8
Group 1: 104 (66.7%)
Group 2: 27 (58.7%)
Dominant stricture: 47 (23%)
Prior biliary sphincterotomy: 57 (28%)
Prior pancreatic sphincterotomy: 1 (0.5%)
Parlak (2004)Retrospective cohortPSC: 16PSC: 58Mean: 35 ± 11.210 (62.5%)Dominant stricture: 16 (100%)IBD: 10 (63%)
Peiseler (2018)Retrospective cohortPSC: 208PSC: 663Mean: 45.3 (range 25–79)134 (64.4%)Cirrhosis: 138 (66%)IBD: 128 (62%)
Immunosuppressed: 94 (45%)
Ponsioen (2018)Randomized controlled trialBalloon dilation: 30
Stenting: 33
Mean: 40 ± 1445 (69.2%)Dominant stricture: 65 (100%)
Median disease duration: 4–7 years
Prior sphincterotomy: 25 (39%)
IBD: 50 (78%)
Rupp (2019)Retrospective cohort286>1800Median: 33.3209 (73.1%)Dominant stricture: 179 (63%)IBD: 209 (73%)
Thiruvengadam (2016)Retrospective cohortRectal indomethacin: 91
No rectal indomethacin: 90
Von Seth (2015)Retrospective cohortPSC: 141
Non-PSC: 8791
PSC: 141
Non-PSC: 8791
PSC mean: 45 ± 16
Non-PSC mean: 69 ± 16
PSC: 87 (62%)
Non-PSC: 3868 (44%)
Prior sphincterotomy: 26 (18%)

ERCP, endoscopic retrograde cholangiopancreatography; IBD, inflammatory bowel disease; PSC, primary sclerosing cholangitis.