title: Feasibility of endoscopic retrograde cholangiopancreatography-related procedures in hemodialysis patients.
abstract: OBJECTIVE
  The opportunities of endoscopic retrograde cholangiopancreatography (ERCP)-related procedure for hemodialysis (HD) patients have been increasing recently. However, the complication rate of ERCPs in HD patients has not been evaluated sufficiently. We aimed to clarify the feasibility of ERCPs in HD patients.
  
  
  METHODS
  We retrospectively reviewed 76 consecutive ERCPs for HD patients between January 2005 and December 2012 in one university hospital and three tertiary-care referral centers. Endoscopic sphincterotomy (EST) was performed in 21 HD patients. We evaluated the incidence and risk factors for complications of all ERCPs and EST in HD patients.
  
  
  RESULTS
  The incidence of pancreatitis, cholangitis, and cardiopulmonary complications for ERCPs in HD patients was 7.9% (6/76), 1.3% (1/76), and 1.3% (1/76), respectively. The mortality rate was 2.6% (2/76), and it occurred after acute pancreatitis in one patient and pneumonia in the other patient. The incidence of hemorrhage and pancreatitis with EST was 19% (4/21) and 4.8% (1/21), respectively. The duration of HD was significantly longer in the patients with hemorrhage after EST than without (19.5 vs 6 years; P = 0.029).
  
  
  CONCLUSIONS
  ERCP is feasible in HD patients. However, EST is not advisable because of the high hemorrhage rate, particularly for patients with a long duration of HD.
authors.affiliation: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Hori
authors.forename: Itaru
authors.initials: I
authors.lastname: Naitoh
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hayashi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miyabe
authors.forename: Shuya
authors.initials: S
authors.lastname: Shimizu
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kondo
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yamashita
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Umemura
authors.forename: Tessin
authors.initials: T
authors.lastname: Ban
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Okumura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takada
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D002761:Cholangitis / Q000453:epidemiology* / Q000209:etiology*; D000075202:Contraindications; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000209:etiology*; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects* / Q000401:mortality; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors
keywords: complication; endoscopic retrograde cholangiopancreatography; endoscopic sphincterotomy; hemodialysis; hemorrhage