Safety of Endoscopic Retrograde Cholangiopancreatography (ERCP) In Pregnancy: A Systematic Review and Meta-Analysis
First page number:
Last page number:
Introduction ERCP is a technically challenging procedure rarely associated with serious post-procedure complications. Pregnancy promotes cholelithiasis due to hormonal changes and ERCP may be needed during pregnancy. Limited clinical data are available on the outcomes of ERCP in pregnancy due to the limited number of cases. We performed a systematic review and a meta-analysis to assess the safety of ERCP in pregnancy. Methods A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through November 20th, 2017 using PRISMA and MOOSE guidelines identified 26 studies that reported the outcomes of ERCP in pregnancy. Random-effects pooled event rate and 95% confidence intervals were estimated. Heterogeneity was measured by I2 and meta-regression analysis was conducted. Results 26 studies reporting on 1298 pregnant patient who underwent ERCP were identified. Median age was 27.1 years. The pooled event rate for overall non-pregnancy related complications in pregnant patients was 0.122 (95% CI=0.105-0.142; p-value < 0.01). Sub-group analysis showed that the pooled rates of Post ERCP Pancreatitis (PEP) and bleeding were 0.117 (95%CI=0.100-0.137) p-value < 0.01 and 0.046 (95%CI=0.029-0.073) p-value < 0.01 respectively. The pooled event rate for overall pregnancy-related complications was 0.070 (95% CI 0.035-0.134) p-value < 0.01. Substantial heterogeneity was noted in the analysis. Conclusion ERCP done by experienced endoscopists is a safe procedure during pregnancy with careful selection of cases and limited use of fluoroscopy the maternofetal complications could be reduced.
Azab, M. M.,
Safety of Endoscopic Retrograde Cholangiopancreatography (ERCP) In Pregnancy: A Systematic Review and Meta-Analysis.
Gastrointestinal Endoscopy, 87(6),