Major bleeding events after endoscopic sphincterotomy and endoscopic papillary balloon dilatation in cirrhotic patients: A nationwide population-based cohort study

摘要

Summary Backgrounds and aims: Endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) were two important methods for therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP bleeding is a troublesome issue especially in patients with bleeding tendency, like cirrhotic patients. In viewing the need of a safer method, we thus aimed to evaluate the post-EST or post-EPBD bleeding rate among cirrhotic patients based on Taiwan's National Health Insurance Research Database (NHIRD). Methods: As per one million population data selected from NHIRD, patients who were hospitalized or accessing outpatient clinics for 3 times with a primary diagnosis of liver cirrhosis (ICD-9 codes 571.2 and 571.5) between January 1, 2004 and December 31, 2011, were collected as research subjects. Rates of major gastrointestinal tract bleeding events appeared within 14 days after EST or EPBD in both cirrhosis and non-cirrhosis patients were compared.