Post-ERCP complications, risk factors and management of complications

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is an interventional procedure usedfor the diagnosis and treatment of hepatopancreaticobiliary system diseases. The aim of this study is toevaluate post-ERCP complications, risk factors, and management of complications of ERCP proceduresperformed in the endoscopy unit of our hospital. Materials and Methods: The study retrospectively reviewed 765 patients’ data of ERCP performed by thesame endoscopist for the diagnosis and treatment of hepatopancreaticobiliary diseases at a single centerbetween April 2019 and February 2021. Interventional procedures were reviewed in terms of ERCP indications,procedure-related complications, risk factors for complications, and management of the complications. Results: A total of 765 procedures were carried out. The successful cannulation rate was 91.9%. The mostcommon indicators for the ERCP procedure were choledocholithiasis (43.6%), high levels of cholestasis bio markers/intra-extrahepatic bile duct dilatation (19%) ve removal of bile duct stents (12.5%). The most com mon risk factors were; female gender (60.9%) and younger age (42.3%) for post-ERCP pancreatitis, pre-cut(10.9%) and anticoagulant therapy (7.5%) for bleeding, papillary abnormalities (22.4%) for perforation, andolder age (42.8%) for cholangitis. The most common complications were hyperamylasemia and pancreatitis(17.2%), bleeding (2%), cholangitis (1.83), and perforation (0.65%). Mortality occurred in 0.26% of patientsdue to post-ERCP cholangitis. Conclusion: Understanding the risk factors and early diagnosis and treatment of complications are the waysto reduce morbidity and mortality in the management of post-ERCP complications.