Endoscopic sphincterotomy for cholangitis after recent coronary artery bypass graft surgery

It is particularly attractive to perform endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy for cholangitis due to common bile duct stone because of the increased morbidity and mortality of the alternative therapy of choledochal exploration. The safety of therapeutic ERCP afte...

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Bibliographic Details
Published inSurgical endoscopy Vol. 17; no. 9; pp. 1499 - 1500
Main Authors Katsinelos, P, Dimiropoulos, S, Paroutoglou, G, Tsolkas, P, Galanis, I, Katsiba, D, Baltagiannis, S, Panagiotopoulou, P, Miliou, T, Capelidis, P, Kamperis, E
Format Journal Article
LanguageEnglish
Published Germany Springer Nature B.V 01.09.2003
Subjects
Aged
Anticoagulants - pharmacology
Blood Loss, Surgical - prevention & control
Catheterization
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis - etiology
Cholangitis - surgery
Choledocholithiasis - complications
Choledocholithiasis - surgery
Coronary Artery Bypass
Diabetes Complications
Female
Humans
Male
Middle Aged
Postoperative Complications - surgery
Sphincterotomy, Endoscopic - instrumentation
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Summary:It is particularly attractive to perform endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy for cholangitis due to common bile duct stone because of the increased morbidity and mortality of the alternative therapy of choledochal exploration. The safety of therapeutic ERCP after recent myocardial injury is unknown since there are only five previously reported cases. Three patients underwent therapeutic ERCP after recent coronary artery bypass graft surgery for indication of recent cholangitis due to choledochal stones. Initially, the cholangitis was managed medically in all patients. Endoscopic sphincterotomy (ES) was performed 11, 17, and 14 days after coronary artery bypass graft surgery. The calculi were successfully extracted by sweeping the choledochus with a balloon-tipped catheter or basket in all cases. During ERCP the vital signs remained stable; no cardiac arrhythmias, hemorrhage, or pulmonary complications occurred. Our study demonstrates that therapeutic ERCP is not absolutely contraindicated after recent myocardial injury and suggests that ES is preferable to surgery for cholangitis due to common bile duct stones.
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ISSN:0930-2794
1432-2218
DOI:10.1007/s00464-002-4267-5