Incidence Rates of Post-ERCP Complications: A Systematic Survey of Prospective Studies

Andriulli, Angelo; Loperfido, Silvano; Napolitano, G.; Niro, Grazia; Valvano, Maria Rosa; Spirito, F.; Pilotto, Alberto; Forlano, Rosario

doi:10.1111/j.1572-0241.2007.01279.x

Cited by 958 publications

(817 citation statements)

References 32 publications

(57 reference statements)

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“…Ten-French stents are now the standard caliber, because use of 11.5-Fr plastic stents is more technically challenging and does not increase stent patency [3]. Plastic stents are routinely used to treat benign biliary conditions (BBCs) such as biliary leaks [4][5][6], strictures [7], postsphincterotomy bleeding (post-ES bleeding) [8], and perforations [9,10].…”

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confidence: 99%

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Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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Background Fully covered self-expandable metal stents (FCSEMS) have been used as a rescue therapy for several benign biliary tract conditions (BBC). Long-term stent placement commonly occurs, and prolonged FCSEMS placement is associated with the majority of the complications reported. This study evaluated the duration of stenting and the efficacy and safety of temporary FCSEMS placement for three BBCs: refractory biliary leaks, postsphincterotomy bleeding, and perforations. Methods This was a retrospective case series with longterm follow-up of 25 patients who underwent FCSEMS placement for BBCs. This study included 17 patients with postcholecystectomy refractory biliary leaks who had previously undergone unsuccessful sphincterotomy and plastic stent placement, 4 patients with difficult-to-control postsphincterotomy bleeding, and 4 patients with a perforation following endoscopic sphincterotomy. Stents were removed according to clinical evidence of problem resolution. The review included stenting duration, safe FCSEMS removal, clinical efficacy, complications, and long-term outcomes. During the follow-up period, ERCP and cholangioscopy procedures were performed to exclude the possibility of bile duct lesion development. Results Complete resolution of the initial condition was achieved in all patients. Patients with biliary leaks had a median stent duration time of 16 days (range 7-28 days). Patients with bleeding had stents removed after a median time of 6 days (range 3-15 days). Patients with perforations had their stents removed after a median time of 29.5 days (range 21-30 days). There were no complications related to stenting. Conclusions Temporary placement of a FCSEMS for 30 days or less is an effective rescue therapy for refractory biliary leaks, difficult-to-control post-endoscopic sphincterotomy bleeding, and perforations. Duration of stenting should be different for each type of condition. Stents can be safely removed, and short-term stenting is associated with the absence of early and late complications.

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confidence: 99%

“…Complications following ES can include bleeding [8,9,15] and perforations [9,10]. The incidence of post-ES bleeding varies from 0.76-2 to 10-48 % [8,15], depending on the definition applied.…”

mentioning

confidence: 99%

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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“…ERCP is a demanding procedure associated with significant morbidity (6.85% of AEs) and occasional mortality (0.33%) [69][70][71]. AEs can be divided into general (in common with upper GI endoscopy) and specifically related to bilio-pancreatic handling (bleeding, perforation, infection and pancreatitis).…”

Section: Endoscopic Retrograde Cholangiopancreatography (Ercp)mentioning

confidence: 99%

“…Bleeding is mainly linked to sphincterotomy and in half of the cases is recognized immediately [69]. Clinically significant haemorrhage occurs in 0.1%-2% of sphincterotomies.…”

Section: Endoscopic Retrograde Cholangiopancreatography (Ercp)mentioning

confidence: 99%

“…Perforation occurs in 0.6% of procedures, with an estimated mortality rate of 0.06% [69], however delayed diagnosis and intervention increase mortality up to 23%. The most commonly used classification of ERCP-induced perforation was suggested by Stapfer et al according to that, perforations can be categorized into four types.…”

Section: Endoscopic Retrograde Cholangiopancreatography (Ercp)mentioning

confidence: 99%

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Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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Natural Course vs Interventions to Clear Common Bile Duct Stones

et al. 2014

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Incidence Rates of Post-ERCP Complications: A Systematic Survey of Prospective Studies

Abstract: ERCP remains the endoscopic procedure that carries a high risk for morbidity and mortality. Complications continue to occur at a relatively consistent rate. The majority of events are of mild-to-moderate severity.

Cited by 958 publications

References 32 publications

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Emergencies after endoscopic procedures

Natural Course vs Interventions to Clear Common Bile Duct Stones

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