Patients with kidney disease, heart failure, or liver cirrhosis face significantly worse outcomes after ERCP, a common bile duct procedure. A large US study found these patients had nearly 4x higher odds of in-hospital death and over 3x higher odds of serious complications. They also stayed in the hospital longer and racked up significantly higher costs.
A new study published in Digestive Diseases and Sciences found that patients with chronic kidney disease (CKD), congestive heart failure (CHF), or liver cirrhosis face dramatically worse outcomes when undergoing endoscopic retrograde cholangiopancreatography (ERCP) — a procedure used to treat bile duct and pancreatic conditions. Analyzing over 1.17 million ERCP procedures performed in the US between 2016 and 2022, researchers found that nearly 23% of patients had at least one of these high-risk comorbidities.
Among those patients, the risks were striking. Liver cirrhosis was the strongest predictor of death, while CHF was most strongly tied to serious complications. Patients with comorbidities also spent more time in the hospital and incurred substantially higher costs, adding a financial burden on top of the clinical one.
By the Numbers:
Why it matters: As the population of medically complex patients grows, clinicians performing ERCP need to proactively identify high-risk individuals. The authors recommend multidisciplinary care pathways — including pre-procedure fluid optimization, nutritional support, and closer monitoring — to help mitigate these elevated risks.
