title: Endoscopic Retrograde Cholangiopancreatography in Kidney Transplant Patients: Results From a Single Center.
abstract: OBJECTIVE
  We report the outcomes of endoscopic retrograde cholangiopancreatography procedures performed for diagnostic and therapeutic purposes in patients who had undergone kidney transplant.
  
  
  METHODS
  We retrospectively evaluated the records of kidney transplant patients for January 1993 to December 2014. Endoscopic retrograde cholangiopancreatography was carried out using an Olympus JF240 duodenoscope (tip outer diameter 12.6 mm, working channel diameter 3.2 mm). The procedures were performed by Department of Anesthesiology staff while the patients were deeply sedated, given a combination of midazolam plus propofol.
  
  
  RESULTS
  Data from 21 kidney transplant patients (16 men and 5 women; mean age at endoscopic retrograde cholangiopancreatography 42.6 ± 23.4 y) were evaluated. A total of 23 endoscopic retrograde cholangiopancreatography procedures were performed. The indications were choledocholithiasis in 6 patients (28.6%), common bile duct dilatation plus liver enzyme elevations in 4 patients (19%), liver enzyme elevation alone in 4 (19%), biliary necrotizing pancreatitis in 2 (9.6%), and cholangitis in 5 (23.8%). Hepatobiliary ultrasonography findings showed that 3 patients (14.3%) had absence of gallbladder owing to cholecystectomy, 14 (66.7%) had gallstones, 1 (4.7%) had gallstones with cholecystitis findings, and 3 (14.3%) were normal. Endoscopic retrograde cholangiopancreatography findings were normal in 4 patients (19%), showed cholangitis in 2 (9.6%), choledocholithiasis in 10 (47.6%), bile duct wall irregularities in 2 (9.6%), dilated common bile duct in 2 (9.6%), and cholangiocarcinoma in 1 (4.7%). Sphincterotomy was performed in 16 patients. None of the patients who underwent endoscopic retrograde cholangiopancreatography developed any complications, for example, acute pancreatitis, bleeding, duodenal, or bile duct perforation.
  
  
  CONCLUSIONS
  In kidney transplant patients, endoscopic retrograde cholangiopancreatography is safe and able to provide substantial information for managing biliopancreatic diseases.
authors.affiliation: From the Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Öcal
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Harmancı
authors.forename: Fatih
authors.initials: F
authors.lastname: Ensaroğlu
authors.forename: Murat
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Haldun
authors.initials: H
authors.lastname: Selçuk
authors.forename: Fatih
authors.initials: F
authors.lastname: Hilmioğlu
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation; D054810:Deep Sedation; D020698:Duodenoscopes; D004867:Equipment Design; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D016030:Kidney Transplantation; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D011237:Predictive Value of Tests; D015742:Propofol / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol