P2299 Safety of Radiation versus Non-Radiation Endoscopic Retrograde Cholangiopancreatography (ERCP) in Pregnancy: A Systematic Review and Meta-Analysis

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    *EMBARGOED All research presented at the 2018 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Monday, October 8, 2018, at 8:00 am EDT.


    Mohamed Moneeb Azab, MD

    Mohamed Moneeb Azab, MD

    P2299 Safety of Radiation versus Non-Radiation Endoscopic Retrograde Cholangiopancreatography (ERCP) in Pregnancy: A Systematic Review and Meta-Analysis

    Author Insight from Mohamed Moneeb Azab, MD, Loma Linda University School of Medicine

    What’s new and important here?

    Physiologic changes during pregnancy are known to predispose to biliary disease. Multiparous women are 10 times more likely to develop biliary complications than the general population. The mainstay in biliary intervention is endoscopic retrograde cholangiopancreatography (ERCP), which is both diagnostic and therapeutic. ERCP carries the risk of radiation exposure to the fetus with possible congenital malformation. Non-radiation ERCP techniques were introduced to avoid radiation exposure. No prior studies compared the outcomes of radiation versus non-radiation ERCP in pregnancy. We divided the outcomes into fetal, maternal pregnancy-related, and maternal non-pregnancy-related outcomes. NR-ERCP had a higher safety profile in terms of maternal non-pregnancy-related outcomes with lower rates of PEP and PSB. Regarding fetal outcomes, NR-ERCP showed no superiority to radiation ERCP. No congenital malformations reported in both groups. However, both groups had an increased risk of preterm labor and intrauterine growth retardation. Our findings support the notion that ERCP should continue to be the procedure of choice for bile duct decompression in pregnancy to prevent potentially life-threatening complications to both mother and fetus. Non-radiation techniques may decrease the risk of non-pregnancy-related outcomes, but do not impact fetal or pregnancy-related outcomes.

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    Author Contact
    Mohamed Moneeb Azab, MD, Loma Linda University School of Medicine
    mazab@llu.edu


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