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KMID : 1188320140080060674
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Gut and Liver
2014 Volume.8 No. 6 p.674 ~ p.679
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Endoscopic Retrograde Cholangiopancreatography in Patients with Previous Acute Coronary Syndrome
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Koh Han-Ra
Park Chang-Hwan
Chung Min-Woo
Park Seon-Young
Hong Young-Joon
Jeong Myung-Ho
Kim Hyun-Soo
Choi Sung-Kyu
Rew Jong-Sun
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Abstract
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Background/Aims:Endoscopic retrograde cholangiopancreatography (ERCP) is considered a high-risk procedure in patients with previous acute coronary syndrome (ACS); however, clinical studies are rare in the literature. The aim of this study was to investigate the safety and efficacy of ERCP in patients with previous ACS.
Methods:We retrospectively reviewed the medical records of patients with previous ACS who underwent ERCP between January 2007 and August 2012. The clinical characteristics, ERCP diagnoses, treatment results, and complications were analyzed.
Results:Fifty patients underwent ERCP an average of 41.6 months after ACS. The most common indication for ERCP was calculous cholangitis. After deep biliary cannulation, endoscopic sphincterotomy, biliary stone removal and endoscopic biliary drainage were successfully performed. Immediate postsphincterotomy bleeding occurred in seven patients, which was successfully controlled using endoscopic therapy. Elevation of cardiac troponin I levels were observed in three patients (6%) before ERCP, and all of these patients were diagnosed with pancreatobiliary disease combined with recurrent ACS, which was treated with coronary artery stent insertion (n=2) and balloon angioplasty (n=1).
Conclusions:Therapeutic ERCP is effective and safe in patients with previous ACS. Cardiac troponin I elevation should be considered a warning sign for recurrent ACS in patients who undergo ERCP.
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KEYWORD
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Cholangiopancreatography, endoscopic retrograde, Acute coronary syndrome, Troponin I
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