Complications following endoscopic cholangiopancreatography (ERCP) occur in 0.2%-1.0% of cases and can be generally subdivided in three main groups: non-specific complications, adverse events and specific, major complications. Non-specific complications, as arterial oxygen desaturation, allergic or drug reactions and ab ingestis pneumonia, can occur during all the endoscopic procedures and may be in some cases severe. Among them, arterial oxygen desaturation is the most frequently reported complications during ERCP; in fact, patients having this procedure are generally elderly and require a profound sedation while in the prone position. Hyperamylasemia may be considered as an adverse event that occurs up to 70% of cases after ERCP, even in case of failed cannulation; amylase increases typically peak 90 min to 4 hours after the procedure, are asymptomatic in most cases and resolve within 48 hours, so that they can be generally considered insignificant. Submucosal injection of contrast medium may render difficult the cannulation and, if large amount of contrast is injected can allow to a temporary obstruction to bile and pancreatic juice flow, with increased risk of postprocedure-pancreatitis. Major complications of ERCP are instrumental injuries, cholangitis, pancreatic sepsis (pseudocyst) and acute pancreatitis, with an average incidence respectively of 0.2%, 0.8%, 0.3% and 0.1%. Pancreatitis is still the most common and the most widely feared complications; during ERCP the pancreas is subjected to many types of potential injury that may act independently or in association to induce pancreatitis. Mechanical, chemical, enzymatic, microbiological and allergic factors, as well as patients conditions which are at increased risk to develop postprocedure pancreatitis, are detailed and discussed in depth. Techniques to prevent or limit these complications are also described.
|Translated title of the contribution||Complications of endoscopic cholangiopancreatography (ERCP)|
|Number of pages||9|
|Journal||Giornale Italiano di Endoscopia Digestiva|
|Publication status||Published - 1996|
ASJC Scopus subject areas