ERCP in Cirrhotic Liver Disease

Pre-Procedure Considerations

• The American Association for the Study of Liver Diseases recommends treating active cholangitis with antibiotic coverage before ERCP procedure 1

Diagnostic vs. Therapeutic ERCP

• The European Association for the Study of the Liver suggests limiting ERCP to therapeutic indications only, avoiding purely diagnostic procedures 2, 3, 4

Procedural Outcomes

• The American College of Gastroenterology notes that for acute gallstone pancreatitis with cholangitis, ERCP should be performed within 24 hours despite cirrhosis, as the mortality benefit outweighs procedural risks 1
• The general population has an ERCP complication rate of 4-5.2% with 0.4% mortality, but this increases substantially in decompensated cirrhosis 5, 1