Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy

Thomas Peponis; Nikhil Panda; Trine G Eskesen; David G Forcione; Dante D Yeh; Noelle Saillant; Haytham M A Kaafarani; David R King; Marc A de Moya; George C Velmahos; Peter J Fagenholz

doi:10.1016/j.amjsurg.2018.09.033

Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy

Thomas Peponis, Nikhil Panda, Trine G Eskesen, David G Forcione, Dante D Yeh, Noelle Saillant, Haytham M A Kaafarani, David R King, Marc A de Moya, George C Velmahos, Peter J Fagenholz

Afdeling for Bedøvelse, Operation og TraumeCenter

8 Citationer (Scopus)

Abstract

BACKGROUND: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.

METHODS: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Our primary endpoint was the rate of SSI.

RESULTS: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The former had different preoperative diagnoses compared to non-ERCP patients (choledocholithiasis [35.2%-7.0%], acute cholecystitis [31.2%-76.4%], gallstone pancreatitis [20.5%-16.2%], and cholangitis [13.1%-0.4%], p < 0.001). The rate of SSI was higher in the preoperative ERCP group (11.5%-4.0%, p = 0.005). In a multivariable analysis conversion to open (OR = 2.57, 95% CI = 1.06-6.21, p = 0.037) and preoperative ERCP (OR = 3.12, 95% CI = 1.34-7.22, p = 0.008) were the only independent predictors of SSI.

CONCLUSION: Preoperative ERCP is associated with a threefold increase in the risk of SSI after laparoscopic cholecystectomy.

Originalsprog	Engelsk
Tidsskrift	American Journal of Surgery
Vol/bind	218
Udgave nummer	1
Sider (fra-til)	140-144
Antal sider	5
ISSN	0002-9610
DOI	https://doi.org/10.1016/j.amjsurg.2018.09.033
Status	Udgivet - 2019

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10.1016/j.amjsurg.2018.09.033

Citationsformater

Peponis, T., Panda, N., Eskesen, T. G., Forcione, D. G., Yeh, D. D., Saillant, N., Kaafarani, H. M. A., King, D. R., de Moya, M. A., Velmahos, G. C., & Fagenholz, P. J. (2019). Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy. American Journal of Surgery, 218(1), 140-144. https://doi.org/10.1016/j.amjsurg.2018.09.033

Peponis, T, Panda, N, Eskesen, TG, Forcione, DG, Yeh, DD, Saillant, N, Kaafarani, HMA, King, DR, de Moya, MA, Velmahos, GC & Fagenholz, PJ 2019, 'Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy', American Journal of Surgery, bind 218, nr. 1, s. 140-144. https://doi.org/10.1016/j.amjsurg.2018.09.033

@article{58ab86b4112a4561bd24823560626afd,

title = "Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy",

abstract = "BACKGROUND: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.METHODS: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Our primary endpoint was the rate of SSI.RESULTS: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The former had different preoperative diagnoses compared to non-ERCP patients (choledocholithiasis [35.2%-7.0%], acute cholecystitis [31.2%-76.4%], gallstone pancreatitis [20.5%-16.2%], and cholangitis [13.1%-0.4%], p < 0.001). The rate of SSI was higher in the preoperative ERCP group (11.5%-4.0%, p = 0.005). In a multivariable analysis conversion to open (OR = 2.57, 95% CI = 1.06-6.21, p = 0.037) and preoperative ERCP (OR = 3.12, 95% CI = 1.34-7.22, p = 0.008) were the only independent predictors of SSI.CONCLUSION: Preoperative ERCP is associated with a threefold increase in the risk of SSI after laparoscopic cholecystectomy.",

keywords = "Endoscopic retrograde cholangio-pancreatography, ERCP, Laparoscopic cholecystectomy, Surgical site infection",

author = "Thomas Peponis and Nikhil Panda and Eskesen, {Trine G} and Forcione, {David G} and Yeh, {Dante D} and Noelle Saillant and Kaafarani, {Haytham M A} and King, {David R} and {de Moya}, {Marc A} and Velmahos, {George C} and Fagenholz, {Peter J}",

note = "Copyright {\textcopyright} 2018. Published by Elsevier Inc.",

year = "2019",

doi = "10.1016/j.amjsurg.2018.09.033",

language = "English",

volume = "218",

pages = "140--144",

journal = "American Journal of Surgery",

issn = "0002-9610",

publisher = "Elsevier Inc.",

number = "1",

}

TY - JOUR

T1 - Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy

AU - Peponis, Thomas

AU - Panda, Nikhil

AU - Eskesen, Trine G

AU - Forcione, David G

AU - Yeh, Dante D

AU - Saillant, Noelle

AU - Kaafarani, Haytham M A

AU - King, David R

AU - de Moya, Marc A

AU - Velmahos, George C

AU - Fagenholz, Peter J

PY - 2019

Y1 - 2019

N2 - BACKGROUND: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.METHODS: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Our primary endpoint was the rate of SSI.RESULTS: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The former had different preoperative diagnoses compared to non-ERCP patients (choledocholithiasis [35.2%-7.0%], acute cholecystitis [31.2%-76.4%], gallstone pancreatitis [20.5%-16.2%], and cholangitis [13.1%-0.4%], p < 0.001). The rate of SSI was higher in the preoperative ERCP group (11.5%-4.0%, p = 0.005). In a multivariable analysis conversion to open (OR = 2.57, 95% CI = 1.06-6.21, p = 0.037) and preoperative ERCP (OR = 3.12, 95% CI = 1.34-7.22, p = 0.008) were the only independent predictors of SSI.CONCLUSION: Preoperative ERCP is associated with a threefold increase in the risk of SSI after laparoscopic cholecystectomy.

AB - BACKGROUND: We sought to examine whether preoperative endoscopic retrograde cholangio-pancreatography (ERCP) increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy.METHODS: Patients admitted to an academic hospital from 2010 to 2016, who were older than 18 and had a laparoscopic or a laparoscopic converted to open cholecystectomy for complicated biliary tract disease were included. We compared those who had a preoperative ERCP to those who did not. Our primary endpoint was the rate of SSI.RESULTS: A total of 640 patients were included. Of them, 122 (19.1%) received preoperative ERCP and 518 (80.9%) did not. The former had different preoperative diagnoses compared to non-ERCP patients (choledocholithiasis [35.2%-7.0%], acute cholecystitis [31.2%-76.4%], gallstone pancreatitis [20.5%-16.2%], and cholangitis [13.1%-0.4%], p < 0.001). The rate of SSI was higher in the preoperative ERCP group (11.5%-4.0%, p = 0.005). In a multivariable analysis conversion to open (OR = 2.57, 95% CI = 1.06-6.21, p = 0.037) and preoperative ERCP (OR = 3.12, 95% CI = 1.34-7.22, p = 0.008) were the only independent predictors of SSI.CONCLUSION: Preoperative ERCP is associated with a threefold increase in the risk of SSI after laparoscopic cholecystectomy.

KW - Endoscopic retrograde cholangio-pancreatography

KW - ERCP

KW - Laparoscopic cholecystectomy

KW - Surgical site infection

U2 - 10.1016/j.amjsurg.2018.09.033

DO - 10.1016/j.amjsurg.2018.09.033

M3 - Journal article

C2 - 30473225

SN - 0002-9610

VL - 218

SP - 140

EP - 144

JO - American Journal of Surgery

JF - American Journal of Surgery

IS - 1

ER -

Preoperative endoscopic retrograde cholangio-pancreatography (ERCP) is a risk factor for surgical site infections after laparoscopic cholecystectomy

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