Incidence and Risk Factors Associated with Endoscopic Retrograde Cholangiopancreatography-Related Bleeding

dc.contributor.advisorForbes, Nauzer
dc.contributor.advisorHeitman, Steven
dc.contributor.authorBishay, Kirles
dc.contributor.committeememberHilsden, Robert
dc.contributor.committeememberBridges, Ron
dc.date2022-11
dc.date.accessioned2022-07-14T16:40:00Z
dc.date.available2022-07-14T16:40:00Z
dc.date.issued2022-06
dc.description.abstractEndoscopic retrograde cholangiopancreatography (ERCP) is the cornerstone of therapy for an array of pancreaticobiliary disorders. While highly effective, ERCP-related bleeding is a possible adverse event with an estimated incidence of 2% which can lead to substantial morbidity and mortality. This thesis reports the results of two studies performed with the aim of evaluating the incidence of and risk factors associated with the development of ERCP-related bleeding. Our meta-analysis of observational and randomized trials showed that while the contemporary incidence of bleeding is in keeping with historical estimates, bleeding risk varies considerably within several important patient- and procedure-related subgroups. We then demonstrated via a multicenter prospective cohort study the risk factors associated with both intraprocedural and clinically significant delayed ERCP-related bleeding. We demonstrated that patient sex, kidney disease, papilla morphology, antithrombotic use and procedural techniques contribute to bleeding risk after adjusting for important covariates. Together, these findings demonstrate that bleeding risk in ERCP varies substantially depending on several factors. Clinicians performing ERCP can use our findings to accurately assess bleeding risk permitting tailored risk mitigation management amongst individuals at high risk and to communicate accurate bleeding risk estimates to patients for conferral of informed consent.en_US
dc.identifier.citationBishay, K. (2022). Incidence and risk factors associated with endoscopic retrograde cholangiopancreatography-related bleeding (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/39903
dc.identifier.urihttp://hdl.handle.net/1880/114836
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subject.classificationEpidemiologyen_US
dc.subject.classificationMedicine and Surgeryen_US
dc.titleIncidence and Risk Factors Associated with Endoscopic Retrograde Cholangiopancreatography-Related Bleedingen_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrueen_US
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