Original ArticlesRisk factors for complications after performance of ERCP☆
Section snippets
Patients and methods
A prospective, single-center study was conducted of postprocedure complications associated with 1223 consecutive ERCPs performed over 31 months. The study was conducted in accordance with the Helsinki Declaration. All patients signed an informed consent for the procedure. Diagnostic and therapeutic procedures in both inpatients and outpatients were included. All procedures were performed with standard duodenoscopes. In the majority of cases, procedures were started by a doctor in the fourth
Results
A total of 1223 patients (733 [60%] women, 490 [40%] men; mean age 53 years, range 17-101 years) underwent ERCP. The procedure was diagnostic in 554 (45.3%) and therapeutic in 667 (54.7%), although the majority of patients were referred for an expected therapeutic ERCP. Sphincterotomy was performed in 213 patients, bile duct stents were placed in 209, pancreatic stents in 94, and metallic stents in 73.
The overall post-ERCP complication rate was 11.2% (Table 1).
Discussion
Since the introduction of endoscopic sphincterotomy and the development of biliary stents, ERCP has become an essential diagnostic and therapeutic modality for the management of a variety of pancreatic and biliary diseases. Early studies of the safety of ERCP were usually retrospective.1, 3, 5, 6, 7 More recent studies have been prospective, but these have focused primarily on the complications of therapeutic ERCP.8 Herein, the results are reported of a large prospective study of the safety of
References (15)
- et al.
Pancreatic injury following ERCP. Failure of prophylactic benefit of Trasylol
Gastrointest Endosc
(1977) - et al.
Therapeutic ERCP in outpatients
Gastrointest Endosc
(1997) - et al.
Outpatient therapeutic ERCP with endobiliary stent placement for malignant common bile duct obstruction
Gastrointest Endosc
(1999) - et al.
A comparison of nonionic versus ionic contrast media: results of a prospective, multicenter study
Gastrointest Endosc
(1995) - et al.
Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction
Gastroenterology
(1998) - et al.
Complications of endoscopic retrograde cholangiopancreatography (ERCP): A study of 10000 cases
Gastroenterology
(1996) - et al.
Complications of fiberoptic gastrointestinal endoscopy—Five years experience in a central hospital
Endoscopy
(1987)
Cited by (507)
Postendoscopic Retrograde Cholangiopancreatography Pancreatitis Pathophysiology and Prevention
2023, Gastrointestinal Endoscopy Clinics of North AmericaPrevention and Management of Complications of Biliary Endoscopy
2022, Gastrointestinal Endoscopy Clinics of North AmericaBringing down the hammer on difficult biliary cannulation
2022, Gastrointestinal EndoscopyPost-ERCP Pancreatitis Risk Factors: Is Post-Sphincterotomy Bleeding Another Risk Factor?
2024, Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
- ☆
Reprint requests: David L. Carr-Locke, MD, FRCP, Director of Endoscopy, 75 Francis St., Brigham & Women's Hospital, Boston, MA 02115.