Increased incidence of gastric food retention during endoscopic retrograde cholangiopancreatography in liver transplant recipients: A retrospective cohort study.

BACKGROUND: Gastric food retention during endoscopic retrograde cholangiopancreatography (ERCP) can lead to complications such as aspiration and failed procedure. Liver transplant (LT) recipients are exposed to an increased risk of impaired gastrointestinal motility due to surgical alterations, immunosuppressive therapy, and post-transplant complications. Given the high frequency of ERCP in this population, our anecdotal experience suggests an increased incidence of gastric food retention at the time of the procedure. AIM: To evaluate the association between LT and gastric food retention observed at ERCP over a two-year period. METHODS: This retrospective study included all patients who underwent standard ERCP at our institution between 2022 and 2024. Data were collected on demographics, medical history including LT and procedural details. RESULTS: A total of 1100 patients underwent ERCP, including 238 LT recipients (22%). Gastric food retention was observed 17 patients (1.5%). The incidence was significantly higher in LT recipients compared to non-transplant patients (3.8% vs 0.9%, P = 0.004). Multivariate analysis confirmed that LT recipients were independently associated with an increased risk of food retention. CONCLUSION: LT recipients demonstrated over three-fold increased incidence of gastric food retention during ERCP. This should be considered in pre-procedural assessment and preparation in this patient population.