Colangiopancreatografia retrógrada endoscópica (CPRE): análise das indicações e complicações no Hospital Universitário Presidente Dutra
DOI:
https://doi.org/10.34119/bjhrv6n2-084Keywords:
Colangiopancreatografia Retrógrada endoscópica, CPRE, indicações e complicações terapêuticasAbstract
Introdução: A CPRE é um procedimento no qual um endoscópio é utilizado para acessar a via biliar e pancreática radiologicamente por meio de injeção de contraste, possibilitando diagnósticos e resoluções terapêuticas. Objetivos: Avaliar as indicações e complicações de CPRE de pacientes adultos no HUUFMA Métodos: Consiste em um estudo observacional, retrospectivo, transversal, com amostra de 112 pacientes submetidos a CPRE no Hospital Universitário Presidente Dutra, no período de janeiro de 2018 a dezembro de 2022. Resultados: A maioria era do sexo feminino (60%), maiores de 40 anos (76%). A principal indicação de CPRE do nosso serviço foi devido a coledocolitíase (71%), entretanto outras indicações relevantes foram em caso de obstrução neoplásica da via biliar, estenose biliar, fístula biliar e papilite. Nossa taxa de complicação foi de 7% de complicações como sangramento e pancreatite. Conclusão: nossos dados epidemiológicos são compatíveis com os dados encontrados na literatura, bem como nossas taxas de complicações. Entretanto, devemos mitigar as complicações criando protocolos par acompanhamento e gerenciamento dos pacientes que apresentam essas complicações.
References
LYU, Yunxiao; WANG, Bin; YE, Shenjian; CHENG, Yunxiao. Impact of the Timing of Endoscopic Retrograde Cholangiopancreatography for the Treatment of Acute Cholangitis: a meta-analysis and systematic review. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, [S.L.], v. , p. 215-229, 11 out. 2022. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1097/sle.0000000000001110.
SUN, Rongjuan; XU, Xiaodan; ZHENG, Qipeng; ZHAN, Jianghua. Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary Diseases: a systematic review and meta-analysis. Frontiers In Pediatrics, [S.L.], v. 10, p. 327-345, 30 jun. 2022. Frontiers Media SA. http://dx.doi.org/10.3389/fped.2022.915085.
MANOHARAN, Dinesh; SRIVASTAVA, Deep Narayan; GUPTA, Arun Kumar; MADHUSUDHAN, Kumble Seetharama. Complications of endoscopic retrograde cholangiopancreatography: an imaging review. Abdominal Radiology, [S.L.], v. 44, n. 6, p. 2205-2216, 27 fev. 2019. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s00261-019-01953-0.
ADLER, Douglas G.; LIEB, John G.; COHEN, Jonathan; PIKE, Irving M.; PARK, Walter G.; RIZK, Maged K.; SAWHNEY, Mandeep S.; SCHEIMAN, James M.; SHAHEEN, Nicholas J.; SHERMAN, Stuart. Quality indicators for ERCP. Gastrointestinal Endoscopy, [S.L.], v. 81, n. 1, p. 54-66, jan. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2014.07.056.
BEN-MENACHEM, Tamir; DECKER, G. Anton; EARLY, Dayna S.; EVANS, Jerry; FANELLI, Robert D.; FISHER, Deborah A.; FISHER, Laurel; FUKAMI, Norio; HWANG, Joo Ha; IKENBERRY, Steven O.. Adverse events of upper GI endoscopy. Gastrointestinal Endoscopy, [S.L.], v. 76, n. 4, p. 707-718, out. 2012. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2012.03.252.
BUXBAUM, James L.; BUITRAGO, Carlos; LEE, Alice; ELMUNZER, Badih Joseph; RIAZ, Ahsun; CEPPA, Eugene P.; AL-HADDAD, Mohammed; AMATEAU, Stuart K.; CALDERWOOD, Audrey H.; FISHMAN, Douglas S.. ASGE guideline on the management of cholangitis. Gastrointestinal Endoscopy, [S.L.], v. 94, n. 2, p. 207-221, ago. 2021. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2020.12.032.
GLOMSAKER, T; HOFF, G; KVALØY, J T; SØREIDE, K; AABAKKEN, L; A SØREIDE, J. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. British Journal Of Surgery, [S.L.], v. 100, n. 3, p. 373-380, 6 dez. 2012. Oxford University Press (OUP). http://dx.doi.org/10.1002/bjs.8992.
KAPRAL, Christine; MÜHLBERGER, Andrea; WEWALKA, Friedrich; DULLER, Christine; KNOFLACH, Peter; SCHREIBER, Florian. Quality assessment of endoscopic retrograde cholangiopancreatography. European Journal Of Gastroenterology & Hepatology, [S.L.], v. 24, n. 12, p. 1447-1454, dez. 2012. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1097/meg.0b013e3283583c6f.
KIENBAUER, Melanie; DULLER, Christine; GSCHWANTLER, Michael; PÜSPÖK, Andreas; SCHÖFL, Rainer; KAPRAL, Christine. Österreichisches Benchmarking ERCP: 10-jahresbericht. Zeitschrift Für Gastroenterologie, [S.L.], v. 56, n. 10, p. 1227-1236, 14 ago. 2018. Georg Thieme Verlag KG. http://dx.doi.org/10.1055/a-0661-6068.
SIIKI, A.; TAMMINEN, A.; TOMMINEN, T.; KUUSANMÄKI, P.. ERCP Procedures in a Finnish Community Hospital: a retrospective analysis of 1207 cases. Scandinavian Journal Of Surgery, [S.L.], v. 101, n. 1, p. 45-50, mar. 2012. SAGE Publications. http://dx.doi.org/10.1177/145749691210100109.
SUN, Rongjuan; XU, Xiaodan; ZHENG, Qipeng; ZHAN, Jianghua. Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary Diseases: a systematic review and meta-analysis. Frontiers In Pediatrics, [S.L.], v. 10, p. 327-345, 30 jun. 2022. Frontiers Media SA. http://dx.doi.org/10.3389/fped.2022.915085.
BUONOCORE, Antimo; DIETZE, Niklas; MCINTOSH, Robert D.. Time-dependent inhibition of covert shifts of attention. Experimental Brain Research, [S.L.], v. 239, n. 8, p. 2635-2648, 3 jul. 2021. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s00221-021-06164-y.
FREEMAN, Martin L.. Adverse outcomes of ERCP. Gastrointestinal Endoscopy, [S.L.], v. 56, n. 6, p. 273-282, dez. 2002. Elsevier BV. http://dx.doi.org/10.1016/s0016-5107(02)70025-4.
FAULX, Ashley L.; LIGHTDALE, Jenifer R.; ACOSTA, Ruben D.; AGRAWAL, Deepak; BRUINING, David H.; CHANDRASEKHARA, Vinay; ELOUBEIDI, Mohamad A.; GURUDU, Suryakanth R.; KELSEY, Loralee; KHASHAB, Mouen A.. Guidelines for privileging, credentialing, and proctoring to perform GI endoscopy. Gastrointestinal Endoscopy, [S.L.], v. 85, n. 2, p. 273-281, fev. 2017. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2016.10.036.
JORGENSEN, Jennifer; KUBILIUN, Nisa; LAW, Joanna K.; AL-HADDAD, Mohammad A.; BINGENER-CASEY, Juliane; CHRISTIE, Jennifer A.; DAVILA, Raquel E.; KWON, Richard S.; OBSTEIN, Keith L.; QURESHI, Waqar A.. Endoscopic retrograde cholangiopancreatography (ERCP): core curriculum. Gastrointestinal Endoscopy, [S.L.], v. 83, n. 2, p. 279-289, fev. 2016. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2015.11.006.
Sociedade Brasileira de Endoscopia Digestiva. Colangiopancreatografia endoscópica retrógrada. Disponível em: http://www.sobed.org.br/ Serviços/Guia de Procedimentos/colangiopancreatografia.
Katzarov AK, Dunkov ZI, Popadiin I, Katzarov KS. How to measure quality in endoscopic retrograde cholangiopancreatography (ERCP). Ann Transl Med 2018;6(13):265.
Prochazka Zarate R, Albán Bravo Paredes E, Zegarra Chang A, Corzo Maldonado CD, Delgado Zapata B. Caracterización clínico-radiológica y exploración de Asociación entre el éxito terapéutico y edad en pacientes sometidos a pancreatocolangiografía retrógrada endoscópica en un hospital de tercer nivel de los años 2008 al 2014 em Lima-Perú. Rev Gastroenterol Peru. 2015;35(2): 151-8.
Borges AC, Almeida PC, Furlani SMT, Cury MS, Pleskow DK. Performance de cpre em centro terciário brasileiro: foco em novos fatores de risco, complicações e indicadores de qualidade. ABCD Arq Bras Cir Dig. 2018;31(1):e1348.
EVERHART, James E.; KHARE, Meena; HILL, Michael; MAURER, Kurt R.. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology, [S.L.], v. 117, n. 3, p. 632-639, set. 1999. Elsevier BV. http://dx.doi.org/10.1016/s0016-5085(99)70456-7.
AERTS, R.; PENNINCKX, F.. The burden of gallstone disease in Europe. Alimentary Pharmacology & Therapeutics, [S.L.], v. 18, p. 49-53, 6 out. 2003. Wiley. http://dx.doi.org/10.1046/j.0953-0673.2003.01721.x.
Nalankilli K, Kannuthurai S, Moss A. A modern approach to ERCP: Maintaining efficacy while optimising safety. Dig Endosc 2016; 28(Suppl 1): 70–76.
Gurung RB, Purbey B, Koju R, Bedi TRS. Endoscopic Retrograde Pancreato Cholangiography (ERCP) at Dhulikhel hospital: Outcome Analysis. Kathmandu UnivMed J 2014;45(1):55-59.
GLOMSAKER, T; HOFF, G; KVALØY, J T; SØREIDE, K; AABAKKEN, L; A SØREIDE, J. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. British Journal Of Surgery, [S.L.], v. 100, n. 3, p. 373-380, 6 dez. 2012. Oxford University Press (OUP). http://dx.doi.org/10.1002/bjs.8992
TRAP, R.; ADAMSEN, S.; HART-HANSEN, O.; HENRIKSEN, M.. Severe and Fatal Complications After Diagnostic and Therapeutic ERCP: a prospective series of claims to insurance covering public hospitals. Endoscopy, [S.L.], v. 31, n. 2, p. 125-130, fev. 1999. Georg Thieme Verlag KG. http://dx.doi.org/10.1055/s-1999-13659.
ANDRIULLI, Angelo; LOPERFIDO, Silvano; NAPOLITANO, Grazia; NIRO, Grazia; VALVANO, Maria Rosa; SPIRITO, Fulvio; PILOTTO, Alberto; FORLANO, Rosario. Incidence Rates of Post-ERCP Complications: a systematic survey of prospective studies. The American Journal Of Gastroenterology, [S.L.], v. 102, n. 8, p. 1781-1788, ago. 2007. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1111/j.1572-0241.2007.01279.x.
COTTON, P.B.; LEHMAN, G.; VENNES, J.; GEENEN, J.e.; RUSSELL, R.C.G.; MEYERS, W.C.; LIGUORY, C.; NICKL, N.. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointestinal Endoscopy, [S.L.], v. 37, n. 3, p. 383-393, maio 1991. Elsevier BV. http://dx.doi.org/10.1016/s0016-5107(91)70740-2.
COTTON, Peter B.. Analysis of 59 ERCP lawsuits; mainly about indications. Gastrointestinal Endoscopy, [S.L.], v. 63, n. 3, p. 378-382, mar. 2006. Elsevier BV. http://dx.doi.org/10.1016/j.gie.2005.06.046.
TRAP, R.; ADAMSEN, S.; HART-HANSEN, O.; HENRIKSEN, M.. Severe and Fatal Complications After Diagnostic and Therapeutic ERCP: a prospective series of claims to insurance covering public hospitals. Endoscopy, [S.L.], v. 31, n. 2, p. 125-130, fev. 1999. Georg Thieme Verlag KG. http://dx.doi.org/10.1055/s-1999-13659.
CHEN, Min; WANG, Lei; WANG, Yun; WEI, Wei; YAO, Yu-Ling; LING, Ting-Sheng; SHEN, Yong-Hua; ZOU, Xiao-Ping. Risk factor analysis of post-ERCP cholangitis: a single-center experience. Hepatobiliary & Pancreatic Diseases International, [S.L.], v. 17, n. 1, p. 55-58, fev. 2018. Elsevier BV. http://dx.doi.org/10.1016/j.hbpd.2018.01.002.
MANES, Gianpiero; PASPATIS, Gregorios; AABAKKEN, Lars; ANDERLONI, Andrea; ARVANITAKIS, Marianna; AH-SOUNE, Philippe; BARTHET, Marc; DOMAGK, Dirk; DUMONCEAU, Jean-Marc; GIGOT, Jean-Francois. Endoscopic management of common bile duct stones: european society of gastrointestinal endoscopy (esge) guideline. Endoscopy, [S.L.], v. 51, n. 05, p. 472-491, 3 abr. 2019. Georg Thieme Verlag KG. http://dx.doi.org/10.1055/a-0862-0346.
MASCI, E; TOTI, G; A MARIANI,; CURIONI, S; A LOMAZZI,; DINELLI, M; MINOLI, G; CROSTA, C; COMIN, U; A FERTITTA,. Complications of Diagnostic and Therapeutic Ercp: a prospective multicenter study. American Journal Of Gastroenterology, [S.L.], v. 96, n. 2, p. 417-423, fev. 2001. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1111/j.1572-0241.2001.03594.x.
VANDERVOORT, Jo; SOETIKNO, Roy M.; THAM, Tony C. K.; WONG, Richard C. K.; FERRARI, Angelo P.; MONTES, Henry; ROSTON, Alfred D.; SLIVKA, Adam; LICHTENSTEIN, David R.; RUYMANN, Frederick W.. Risk factors for complications after performance of ERCP. Gastrointestinal Endoscopy, [S.L.], v. 56, n. 5, p. 652-656, nov. 2002. Elsevier BV. http://dx.doi.org/10.1067/mge.2002.129086.
STAPFER, Maria; SELBY, R. Rick; STAIN, Steven C.; KATKHOUDA, Namir; PAREKH, Dilipkumar; JABBOUR, Nicolas; GARRY, David. Management of Duodenal Perforation After Endoscopic Retrograde Cholangiopancreatography and Sphincterotomy. Annals Of Surgery, [S.L.], v. 232, n. 2, p. 191-198, ago. 2000. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1097/00000658-200008000-00007.
HOWARD, Thomas J.; TAN, Tzujen; LEHMAN, Glen A.; SHERMAN, Stuart; MADURA, James A.; FOGEL, Evan; SWACK, Michael L.; KOPECKY, Kenyon K.. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery, [S.L.], v. 126, n. 4, p. 658-665, out. 1999. Elsevier BV. http://dx.doi.org/10.1016/s0039-6060(99)70119-4.
MILLER, Rafi; ZBAR, Andrew; KLEIN, Yoram; BUYEVIZ, Victor; MELZER, Ehud; MOSENKIS, Bruce N.; MAVOR, Eli. Perforations following endoscopic retrograde cholangiopancreatography: a single institution experience and surgical recommendations. The American Journal Of Surgery, [S.L.], v. 206, n. 2, p. 180-186, ago. 2013. Elsevier BV. http://dx.doi.org/10.1016/j.amjsurg.2012.07.050.
SANTANA, Júlia Medeiros; BARREIROS, Pâmela Gabrielle Lima; GARCIA, Hamilton Cezar Rocha; MORAES, Andressa de Souza Abirachid; BRANCO, Bianca Barros; BRITO, Carlos Rafael Alves de; CASTRO, Mateus de Souza; PIMENTA, Murilo Brandão; DIAS, Patrícia e Silva; LIMA, Yana de Medeiros Souza. Colecistopatias e o tratamento das suas complicações: uma revisão sistemática de literatura / colecistopathies and the treatment of their complications. Brazilian Journal Of Health Review, [S.L.], v. 4, n. 1, p. 3597-3606, 2021. Brazilian Journal of Health Review. http://dx.doi.org/10.34119/bjhrv4n1-282.
ARGUELLO, Anna Carolina da Costa; CARVALHO, Camila de Quevedo; HERêNIO, Yuree Milhomem Bandeira; BARBOSA, Fernando Grubert Peixoto; MORAIS NETO, Reinaldo Santos; TIBANA, Tiago Kojun; SANTOS, Rômulo Florêncio Tristão; NUNES, Thiago Franchi. Inserção percutânea trans-hepática de prótese nas afecções biliares / Percutaneous transhepatic insertion of prosthesis in biliary diseases. Brazilian Journal Of Health Review, [S.L.], v. 5, n. 2, p. 6539-6543, 14 abr. 2022. South Florida Publishing LLC. http://dx.doi.org/10.34119/bjhrv5n2-225.
