A prospective study of the risk of XXXX in directed cholangioscopic examination of the common bile duct.

@entity1 @entity2259 @entity255
BACKGROUND AND AIMS: The frequency of @entity2259 during ERCP with cholangioscopy has not been well studied. There are no formal guidelines regarding antibiotic prophylaxis before ERCP with cholangioscopy. The aim was to estimate the frequency of @entity2259 and subsequent infectious adverse events after ERCP with cholangioscopy. METHODS: This prospective nonrandomized study performed in a single tertiary referral center included adult @entity1 who were undergoing ERCP with cholangioscopic examination of the common bile duct. Blood cultures were drawn from @entity1 before the procedure and 5 and 30 minutes after the procedure. Antibiotics were not given before or after the procedure. @entity1 were followed up after 24 hours and 1 week after the procedure for infectious adverse events. The primary outcome was @entity2259 rate, and secondary outcomes were @entity255 rate and adverse events. RESULTS: Fifty-seven @entity1 were enrolled in the study with 60 procedures performed. The first procedure from each @entity1 was considered in the analysis, and thus we included 57 @entity1 with 57 procedures in this study analysis. Postprocedure @entity2259 was seen in 5 of 57 procedures (8.8%; 95% confidence interval, 2.9%-19.3%). Four @entity1 were readmitted with @entity255 (7.0%). @entity2259 was more common in @entity1 who had cholangioscopy with biopsy sampling compared with @entity1 who had cholangioscopy without biopsy sampling (P  =  .011). @entity255 was significantly more common in @entity1 with @entity2259 than in those @entity1 with a negative blood culture (P  = .035). CONCLUSION: ERCP with cholangioscopy is associated with a @entity2259 rate of 8.8% and a @entity255 rate of 7.0%. Preprocedural antibiotics may be considered before cholangioscopy, especially if tissue acquisition with biopsy sampling is expected. (Clinical trial registration number: NCT01673269.).
