Successful ERCP Application in Pregnant Women with Cholestasis

Abstract Aims: We aimed to present successful endoscopic retrograde cholangiopancreatography (ERCP) applications and results in our pregnant cases. Method: The data of 14 successful ERCP applications in our pregnant patients between 2016 and 2022 were evaluated retrospectively. ERCP procedure was performed by endoscopists experienced in biliary endoscopy while the patients were on the left decubitus position. Fluoroscopy was performed using methods to reduce fetal radiation exposure. Short-term fluoroscopy were used during the procedure. Fluoroscopy times applied to the patient were recorded. Results: ERCP and sphincterotomy were applied to 14 pregnant women who presented with cholestasis findings. Two of the procedures were performed aproprate trimesters in whole patients. The mean maternal age in our pregnant women was 24.8±5.6 (19-38), mean gestational age was 17.8 weeks (10-34w). The fluoroscopy time was 0.16 min (0-35sec). Fetal radiation exposure was negligible in 10 pregnant women (10 sec) and between 10-14 seconds in 4 pregnant women. The estimated fetal radiation exposure of the two women was between 30 and 35 seconds. Procedure-related complications were one minimal bleeding after sphincterotomy, two hyperamylasemia after ERCP, and one acute respiratory distress syndrome. Cholecystitis developed in one pregnant woman two days after ERCP. Conclusion: When necessary precautions are taken under the control of a multidisciplinary team, ERCP can be safely applied during pregnancy, and successful results can be obtained.