Evidence map›Paper›PMID 30859489›Full record

ArticleSurgical endoscopy2020

ERCP-related perforation: an analysis of operative outcomes in a large series over 12 years.

Nilesh Sadashiv Patil, Nisha Solanki, Pramod Kumar Mishra, Barjesh Chander Sharma, Sundeep Singh Saluja

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 32 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. The effect of using nitroderm TTS in ERCP on precut, selective cannulation, and bleeding.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023
    Article
  11. Review
  12. Article
  13. Article
  14. Recent advances in prevention and management of endoscopic retrograde cholangiopancreatography-related duodenal perforation.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021
    Review
  15. Article
  16. Article
  17. Review
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Nilesh Sadashiv PatilDepartment of HPB Surgery & Liver Transplantation, Institute of Liver & Biliary Sciences, New Delhi, 110070, India. dr.nils.p@gmail.com.
Nisha SolankiDepartment of Gastrointestinal Surgery & Liver Transplantation, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Pramod Kumar MishraDepartment of Gastrointestinal Surgery & Liver Transplantation, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Barjesh Chander SharmaDepartment of Medical Gastroenterology, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Sundeep Singh SalujaDepartment of Gastrointestinal Surgery & Liver Transplantation, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Institute of Post Graduate Medical Education and Research · INInstitute of Liver and Biliary Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforation is a rare but serious adverse event of endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to determine the predictors of morbidity and mortality after surgical management of ERCP-related perforation (EP).

methodsThe records of patients with EP requiring surgical intervention at a tertiary referral center in a 12-year period (2004-2016) were retrospectively analyzed for demography, indications for ERCP, risk factors, timing and type of surgical repair, post-operative course, hospital stay, and outcome. Multiple logistic regression was used to identify the parameters predicting survival.

resultsOf 25,300 ERCPs, 380 (1.5%) had EP. Non-operative management was successful in 330 (86.8%) patients. 50 (13.2%) patients were operated for EP. Out of 50, the perforation was detected during ERCP (intra-procedure) in 32 patients (64%). In 30 patients (60%), the surgery was performed within 24 h of ERCP. Twenty patients underwent delayed surgery (after 24 h of ERCP) following the failure of initial non-operative management. The delayed surgery after an unsuccessful medical treatment had a detrimental effect on morbidity, mortality and hospital stay. Post-operative duodenal leak was the only independent predictor of 90-day mortality (p = 0.02, OR = 9.1, 95% CI 1.52-54.64). Addition of T-tube duodenostomy (TTD) to the primary repair for either type I or type II perforations increased post-operative duodenal leak (type I, p = 0.048 and type II; p = 0.001) and mortality (type I, p = 0.009 and type II, p = 0.045).

conclusionAlthough EP is a rare event, it has a serious impact on morbidity and mortality. Delaying of surgery following failed non-operative management worsens the prognosis. Addition of TTD to the repair is not helpful in these patients.

Indexed as

Conservative TreatmentIntestinal PerforationReoperationCholangiopancreatography, Endoscopic RetrogradeDelayed DiagnosisFemaleHumansMaleMiddle AgedMortalityRetrospective StudiesRisk FactorsTime-to-TreatmentCholangiopancreatography, endoscopic retrogradeDuodenostomyMedical treatmentMorbidityRisk factors

Identifiers

PMID30859489
OpenAlexW2920956015

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.