Preoperative gastric retention in endoscopic retrograde cholangiopancreatography.

We comment on the article by Jia et al, in the World Journal of Gastrointestinal Surgery. We focus mainly on the factors that impair gastric motility and cause gastric retention in the pre-operative setting of endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a complex endoscopic therapeutic procedure, which demands great skill from the endoscopist but also has recognized complications. Gastric retention impairs the endoscopist's visibility but also increases the risk of complications, such as aspiration pneumonia. Therefore, identifying the factors that predispose to gastric retention alerts the endoscopists of the possible risks and enables them to take evasive action. The authors in the current study by Jia et al developed and validated a predictive model, which incorporates five different factors, i.e., gender, primary disease, jaundice, opioid use, and gastrointestinal obstruction, which were found to influence gastric retention. This model was shown to have a high predictive value to accurately identify patients at risk for gastric retention before a therapeutic ERCP.