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Updated: Nov 23, 2025

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
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Antibiotic prophylaxis in ERCP with failed cannulation.

Greger Olsson1,2, Lars Enochsson3, Fredrik Swahn4,5,6

  • 1Department of Surgery, Central Hospital, Växjö, Sweden.

Scandinavian Journal of Gastroenterology
|January 5, 2021
PubMed
Summary
This summary is machine-generated.

Prophylactic antibiotics significantly reduced overall and infectious complications in patients undergoing ERCP with failed biliary cannulation. This finding supports the use of antibiotics to improve patient outcomes in these procedures.

Keywords:
ERCPProphylactic antibioticsadverse eventsendoscopic retrograde cholangiopancreatographyperi-procedural complicationspostoperative complications

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) with failed biliary cannulation is linked to increased adverse events.
  • The efficacy of prophylactic antibiotics in mitigating these complications remains uncertain.

Purpose of the Study:

  • To determine if prophylactic antibiotics reduce overall adverse complications during ERCP when biliary cannulation fails.
  • To assess the impact of antibiotic prophylaxis on specific infectious complications post-ERCP.

Main Methods:

  • Analysis of a large national quality registry dataset (GallRiks) of ERCP procedures performed between 2006 and 2018.
  • Inclusion of 4,996 ERCPs with failed biliary cannulation, excluding those with successful cannulation or prior antibiotic use.
  • Comparison of complication rates between patients who received prophylactic antibiotics and those who did not.

Main Results:

  • A 24% adjusted odds reduction in overall complications was observed in the antibiotic prophylaxis group (13.6% vs. 17.1%).
  • Infectious complications and abscess rates were significantly lower with prophylaxis (2.1% vs. 3.2% and 0.8% vs. 1.4%, respectively).
  • No significant difference in cholangitis rates was found between the groups.

Conclusions:

  • Prophylactic antibiotic administration is associated with a significant reduction in overall and infectious complications following ERCP with failed biliary cannulation.
  • These findings suggest that prophylactic antibiotics are beneficial in managing patients experiencing difficult biliary cannulation during ERCP.
  • The study highlights the importance of antibiotic prophylaxis in improving safety profiles for specific ERCP scenarios.