Safety and Efficacy of ERCP in Cirrhotic Patients with Obstructive Jaundice

Background: Endoscopic retrograde cholangiopancreato-graphy (ERCP) is a primary treatment option for various pancreatobiliary disorders. However, there is a lack of prospective studies on the safety of ERCP in cirrhotic patients, with conflicting results. This study aims to compare the outcomes of ERCP in cirrhotic patients with those in non-cirrhotic patients. Methods: In this prospective study, 54 cirrhotic patients undergoing therapeutic ERCP were com-pared to 65 non-cirrhotic patients in a control group. Basic pre-endoscopic and interventional data, as well as 30-day follow-up data, were collected and analyzed. Patients were assessed for the development of complications and the success of the procedure. Results: There was no significant difference between cirrhotic and non-cirrhotic patients in terms of overall complication rates (11.1% vs 12.3%, P=0.84) and individual complications. Clinical success was slightly higher in the non-cirrhotic group, but the difference was not statistically significant (87.7% vs 79.6%, P=0.478). Indep-endent predictors of mortality among our patients included a history of variceal bleeding, splenomegaly, ascites, and post-ERCP cholangitis. The cirrhotic group experienced a significant delay in the improvement of serum bilirubin levels. Conclusion: ERCP is considered safe and effective in cirrhotic patients, with clinical success rates comparable to non-cirrhotic patients. However, in cirrhotic patients with advanced liver disease, there may be a delay in the improvement of serum bilirubin levels.