Complications of ERCP: a prospective study

Christensen, Merete Sanvig; Matzen, Peter; Schulze, Svend; Rosenberg, Jacob

doi:10.1016/s0016-5107(04)02169-8

Cited by 400 publications

(310 citation statements)

References 44 publications

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“…1 In general, the CBD is considered dilated if over 7mm 2,3 and the pancreatic duct is considered dilated if over 3 mm in the head of the pancreas but the diameter of the pancreatic duct does increase with age. 4,5 Endoscopic retrograde cholangiopancreatography (ERCP) had been the standard for evaluating a dilated common bile duct or pancreatic duct for many years, 6 but with complications such as post-ERCP pancreatitis, 7 other methods to evaluate the CBD and PD have been utilized more often. Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) are often selected to further evaluate patients with a dilated PD or CBD given their favorable complication profile.…”

Section: Introductionmentioning

confidence: 99%

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Carriere¹,

Conway²,

Evans³

et al. 2012

jig

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Background:Patients with dilated common bile duct (CBD) (>7mm) and/or pancreatic duct (PD) on abdominal imaging are often referred for endoscopic ultrasound (EUS). In many cases, the EUS shows no obvious etiology for the dilated ducts. Objective: Find clinical factors that may predict which patients are more likely to have positive findings on EUS to explain the etiologies for the dilated ducts. Design: Retrospective database analysis. Setting: Tertiary-care university hospital. Patients: Patients referred for EUS for dilated CBD and/or PD from January 2004 to February 2010 were included in this study. Only patients without an obvious etiology for the dilated ducts on abdominal imaging were included. Interventions: An EUS was performed by using either a radial echoendoscope or a linear endoscope to evaluate the common bile duct and/or the pancreatic duct. When appropriate fine needle aspiration of the mass or cyst was performed. Main Outcome Measurements: The characteristics of patients who had positive findings on EUS to explain the etiology of their dilated PD and/or CBD. Results: A total of 140 patients were included in the study with a mean age of 64 years, 51 (36%) male and 115 (82%) white. The majority of our patients had a presenting symptom of abdominal pain 105 (75%). 49 (36%) had elevated AST or ALT, 25 (8%) had an elevated bilirubin and 13 (23%) had an elevated lipase. EUS findings explained the dilated ducts in 54 (39%) of our patients, most common diagnoses included: CBD stone in 11 (8%), non-calcific chronic pancreatitis in 9 (6%), pancreatic mass in 8 (6%), IPMN in 7 (5%). On bivarate analysis patients who were older (p = 0.006), male (p = 0.001), had elevated LFTs (p = <0.001), had elevated lipase (p = 0.021) or had dilated CBD and PD (p = 0.007) were more likely to have an etiology for their dilated duct(s) discovered on EUS. Limitations: A retrospective study with a small number of patients. Conclusion: Older patients, males and those patients presenting with concurrent elevations in the AST/ALT and/or lipase were more likely to have an underlying etiology discovered on EUS. Furthermore, EUS may detect an undiagnosed pancreatic malignancy in patients presenting with unexplained duct dilation.

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Section: Introductionmentioning

confidence: 99%

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Carriere¹,

Conway²,

Evans³

et al. 2012

jig

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“…10 There is wide disparity but the most accurate overall risk of PEP from prospective studies ranges from 3%-10%. 1,4,5,[11][12][13][14][15][16] A survey of prospective studies in 2007 reported that about 10% of PEP cases were graded as severe and the overall mortality of PEP was 3%. 1 …”

Section: Post-ercp Pancreatitismentioning

confidence: 99%

“…1 Most concerning is that ERCP has a high likelihood for very serious sequelae including fatal outcomes in about 0.33%-1% of cases. [1][2][3][4][5][6] There is also a considerable medicolegal risk associated with ERCP complications. 7 A combination of complications, e.g., pancreatitis, perforation, and/ or cardiopulmonary events can be devastating.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…La perforación tiene un riesgo de mortalidad de 0,1%-1% (4,5), pero, si hay retraso en el diagnóstico, puede ser hasta del 8%-23% (5,6). El tratamiento, dependiendo de varios factores, puede ser médico (nada por vía oral, antibióticos y analgesia endovenosos) o quirúrgico.…”

Section: Introductionunclassified

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

M¹,

P²,

et al. 2017

Rev. Colomb. Gastroenterol.

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La perforación duodenal posterior a la colangiopancreatografía endoscópica (CPRE) es una complicación infrecuente que sucede en un 0.1-0.6% de los casos. El manejo (quirúrgico o no quirúrgico) depende de varios factores. Presentamos el caso de una mujer que sufrió una perforación duodenal pos-CPRE manejada conservadoramente con un stent biliar metálico autoexpandible (SMAE) totalmente recubierto y antibióticos, quien no requirió manejo quirúrgico.

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Complications of ERCP: a prospective study

Cited by 400 publications

References 44 publications

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

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