Readmission rate and complications following biopsy of the ampulla of Vater—A retrospective data analysis. Issue 4 (28th March 2023) - Rosella, Sam
Abstract: Background and Aim: Obtaining endoscopic biopsies from the ampulla of Vater is important for the diagnosis of lesions that are suspicious for neoplasia. The clinical safety profile is not well defined in the literature. Our aim was to evaluate the procedure‐related readmission rate and complications from ampullary biopsy in patients undergoing duodenoscopy and endoscopic retrograde cholangiopancreatography (ERCP). Methods: A retrospective data analysis was performed on adult patients at Austin Hospital who underwent ampullary biopsies between 1 January 2010 and 1 March 12022. Medical records were identified using pathology databases. The electronic health record was reviewed for baseline characteristics including demographics, date, indication for ampullary biopsy, procedure type (duodenoscopy or ERCP), and procedural associated interventions during ERCP. Readmissions to the Austin Emergency Department within 30 days following the biopsy were identified, and complications were noted. Results: A total of 506 records were reviewed and 246 episodes of ampullary biopsy met the inclusion criteria. The procedure‐related readmission rate for all episodes was 6.1%, which included pain (3.3%), pancreatitis (2.0%), cholangitis (1.6%), and bleeding (0.8%). Ampullary biopsies with ERCP had a procedure‐related readmission rate of 8.4%, whereas ampullary biopsies without ERCP had a rate of 2.2%. Increased readmissions and complications were associated with male sex ( P = 0.01 and P = 0.05, respectively). There was no association between the number of biopsies taken and complications. Conclusion: Performing an ampullary biopsy without an associated ERCP carries a low rate of clinical complications and procedure‐related readmissions. The combination of ERCP and ampullary biopsy increases the risk four‐fold. Abstract : There is a paucity of data relating to the clinical safety profile of performing biopsy of the ampulla of Vater. We have performed a retrospective data analysis on adult patients undergoing ampullary biopsy to evaluate the procedure‐related readmission rate and complications from ampullary biopsy during endoscopic retrograde cholangiopancreatography (ERCP) and duodenoscopy. Our series consists of the largest sample size of ampullary biopsies known in the literature to date. We have found that whilst ampullary biopsy without an associated ERCP carries a low rate of procedure‐related readmissions and clinical complications, the combination of ERCP and ampullary biopsy increases the risk four‐fold.