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.
Complications of endoscopic retrograde cholangiopancreatography (ERCP): A study of 10000 cases
Gastroenterology
(1996) - et al.
Pancreatic injury following ERCP. Failure of prophylactic benefit of Trasylol
Gastrointest Endosc
(1977) - et al.
Complications of fiberoptic gastrointestinal endoscopy—Five years experience in a central hospital
Endoscopy
(1987) - et al.
Post-ERCP pancreatitis: association with urographic visualization during ERCP
Radiology
(1985) - et al.
ERCP- and endoscopic sphincterotomy-induced pancreatitis
Pancreas
(1991) - et al.
Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gallbladder “in situ.”
Gut
(1984) - et al.
Towards safer endoscopic retrograde cholangiopancreatography
Gut
(1993)
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Reprint requests: David L. Carr-Locke, MD, FRCP, Director of Endoscopy, 75 Francis St., Brigham & Women's Hospital, Boston, MA 02115.