Skip to main content

Advertisement

SpringerLink
Log in

Complications of diagnostic and therapeutic ERCP

  • Review
  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Summary

Complications associated with ERCP have been well defined, clinically recognized, and effectively managed conservatively. Few patients require surgery or prolonged hospitalization. The morbidity and mortality associated with ERCP and sphincterotomy have remained low, and, although the outcome of endoscopy is equivalent to or better than surgical or radiologic techniques, the complications are less. Despite the general acceptance of ERCP, its therapeutic applications, its more universal performance, and the morbidity and mortality rates have remained the same or lower since its introduction a quarter of a century ago.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Siegel JH. ERCP: technique, diagnosis and therapy. New York: Raven Press, 1992

    Google Scholar 

  2. Neoptolemos JP, Carr-Locke DL, London NJ, et al. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy vs. conservative treatment for acute pancreatitis due to gallstones. Lancet 1988;2:979–983

    Article  PubMed  CAS  Google Scholar 

  3. Lai EC, Mok FP, Tan ES, et al. Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med 1991;326:1582–1586

    Article  Google Scholar 

  4. Smith AC, Dowsett JF, Russell RCG, et al. Randomised trial of endoscopic stenting vs. surgical bypass in malignant low bile duct obstruction. Lancet 1994;344:1655–1660

    Article  PubMed  CAS  Google Scholar 

  5. Davidison BR, Neoptolemos JF, Carr-Locke DL. Endoscopic sphincterotomy for common bile duct calculi in patients with gall-bladder in situ considered unfit for surgery. Gut 1988;29:114–120

    Article  Google Scholar 

  6. Summerfield JA. Biliary obstruction is best managed by endoscopists. Gut 1988;29:741–745

    Article  PubMed  CAS  Google Scholar 

  7. Siegel JH, Cohen SA, Kasmin FE. Scruples not ruples is therapeutic ERCP being utilized appropriately? Am J Gastroenterol 1995;90:169–170

    PubMed  CAS  Google Scholar 

  8. Sivak MV, Vennes JA, Cotton PB, et al. Advanced training programs in gastrointestinal endoscopy. Gastrointest Endosc 1993;39:462–464

    Article  PubMed  Google Scholar 

  9. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications: an attempt at consensus. Gastrointest Endosc 1991;37:383–393

    Article  PubMed  CAS  Google Scholar 

  10. Cotton PB. Endoscopic management of bile duct stones; (apples and oranges). Gut 1984;25:587–597

    Article  PubMed  CAS  Google Scholar 

  11. Cohen SA, Kasmin FE, Rutkovsky FD, et al. Endoscopic sphincterotomy technique and complications [Abstract]. Am J Gastroenterol 1992;87:1282

    Google Scholar 

  12. Bedford RA, Johnson GK, Geenen JE, et al. Does the use of nonionic contrast prevent post ERCP pancreatitis: results of a prospective multicenter study [Abstract]. Gastroenterology 1993; A294

  13. Freeman M, Nelson D, Sherman S, et al. Pancreatitis from endoscopic sphincterotomy: a prospective, multicenter 30 days study [Abstract]. Gastrointestinal Endosc 1994;40:P108

    Google Scholar 

  14. Sherman S, Ruffolo TA, Hawes RH, et al. Complications of endoscopic sphincterotomy: a prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and non-dilated bile ducts. Gastroenterology 1991;101:1068–1075

    PubMed  CAS  Google Scholar 

  15. Leese T, Neoptolemos JP, Carr-Locke DL. Successes, failures, early complications in their management following endoscopic sphincterotomy: results in 394 prospective patients from a single centre. Br J Surg 1985;72:215–219

    Article  PubMed  CAS  Google Scholar 

  16. Lambert ME, Betts CD, Hill J, et al. Endoscopic sphincterotomy: the whole truth. Br J Surg 1991;78:473–476

    Article  PubMed  CAS  Google Scholar 

  17. Hart R, Classen M. Complications of diagnostic gastrointestinal endoscopy. Endoscopy 1990;22:229–232

    Article  PubMed  CAS  Google Scholar 

  18. Baillie J, Cairns SR, Putnam WS, et al. Endoscopic management of choledocholithiasis during pregnancy. Obstet Gynecol 1990;171:1–4

    CAS  Google Scholar 

  19. Sherman S, Lehman GA. ERCP and endoscopic sphincterotomy induced pancreatitis. Pancreas 1991;6:350–367

    Article  PubMed  CAS  Google Scholar 

  20. Bedford RA, Johnson GK, Geenen JE. Ionic vs non-ionic contrast median: does stepwise therapy influence the incidence of post ERCP pancreatitis. Gastroenterology 1993;104:A294

    Google Scholar 

  21. Neoptolemos JP, Bailey IS, Carr-Locke DL. Sphincter of Oddi dysfunction: results and treatment by endoscopic sphincterotomy. Br J Surg 1988;75:454–459

    Article  PubMed  CAS  Google Scholar 

  22. Stanten R, Frey CF. Pancreatitis after endoscopic retrograde cholangiopancreatography; underreported disease whose severity is often unappreciated. Arch Surg 1990;125:1032–1035

    PubMed  CAS  Google Scholar 

  23. Funnell IC, Bornman PC, Weakley SP. Obesity: an important prognostic factor in acute pancreatitis. Br J Surg 1993;80:484–486

    Article  PubMed  CAS  Google Scholar 

  24. Sarr MG, Fishman EK, Milligan FD, et al. Pancreatitis or duodenal perforation after peri-Vaterian therapeutic endoscopic procedures: diagnosis, differentiation, and management. Surgery 1986;100:461–466

    PubMed  CAS  Google Scholar 

  25. Kuhlam JE, Fishman EK, Milligan FD, et al. Complications of endoscopic retrograde sphincterotomy: computed tomographic evaluation. Gastrointest Radiol 1989;14:127–132

    Article  Google Scholar 

  26. Gerzoff SG, Banks PA, Robbins AH, et al. Early diagnosis of pancreatic infection by computed tomography-guided aspiration. Gastroenterology 1987;93:1315–1320

    Google Scholar 

  27. Byrne P, Leung JWC, Cotton PB. Retroperitoneal perforation during duodenoscopic spincterotomy. Radiology 1984;150:383–384

    PubMed  CAS  Google Scholar 

  28. Savides T, Sherman S, Kadell B, et al. Bilateral pneumothoraces and subcutaneous emphysema after endoscopic sphincterotomy. Gastrointest Endosc 1993;39:814–817

    Article  PubMed  CAS  Google Scholar 

  29. Love L. Radiologic anatomy of the retroperitoneum. In: Taveras JM, Ferrucci JT, eds. Radiology—diagnosis, imaging, intervention, vol. 4. Philadelphia: JP Lippincott, 1990:1–11

    Google Scholar 

  30. Onken J, Baillie J Affronti JP, et al. ERCP in patients following Billroth II gastrectomy: is it tougher and riskier than “ordinary” ERCP? [Abstract]. Gastrointest Endosc 1992;38:257

    Google Scholar 

  31. Booth FVM, Doerr RJ, Khalafi RS, et al. Surgical management of complications of endoscopic sphincterotomy with pre-cut papillotomy. Am J Surg 1990;159:132–135

    Article  PubMed  CAS  Google Scholar 

  32. Shakoor, Tariq, Geene JE. Pre-cut papillotomy. Gastrointest Endosc 1992;38:623–627

    Article  PubMed  CAS  Google Scholar 

  33. Kasmin FE, Cohen DP, Batra SA, et al. Needle-knife sphincterotomy: efficacy in complications [Abstract]. Am J Gastroenterol 1993;88:1534

    Google Scholar 

  34. Bell RC, Stiegmann GV, Goff J, et al. Decision for surgical management of perforation following endoscopic sphincterotomy. Am Surg 1991;57:237–240

    PubMed  CAS  Google Scholar 

  35. Dunham F, Bourgeois N, Gelin M, et al. Retroperitoneal perforation following endoscopic sphincterotomy; clinical course in management. Endoscopy 1982;14:92–96

    Article  PubMed  CAS  Google Scholar 

  36. Freeman M, Nelson D, Sherman S, et al. Hemorrhage from endoscopic sphincterotomy: a prospective, multicenter, 30 day study [Abstract]. Gastrointest Endosc 1994;40:P108

    Google Scholar 

  37. Freeman M, Nelson D, Sherman S. Complications of endoscopic sphincterotomy in cirrhotics: a prospective multicenter study [Abstract]. Gastrointestinal Endosc 1995;41:397

    Article  Google Scholar 

  38. Saeed M, Kadir S, Kaufman SL, et al. Bleeding following endoscopic sphincterotomy: angiographic management by transcatheter embolization. Gastrointest Endosc 1989;35:300–303

    Article  PubMed  CAS  Google Scholar 

  39. Neuhaus B, Safrany L. Compliations of endoscopic sphincterotomy and their treatment. Endoscopy 1981;13:197–199

    Article  Google Scholar 

  40. Classen DC, Jacobson JA, Burke JP, et al. Serious pseudomonas infections associated with endoscopic retrograde cholangiopancreatography. Am J Med 1988;84:590–596

    Article  PubMed  CAS  Google Scholar 

  41. Deviere J, Motte S, Dumonceau JM, et al. Septicemia after endoscopic retrograde cholangiopancreatography. Endoscopy 1990;22:72–75

    Article  PubMed  CAS  Google Scholar 

  42. Leung JWC, Cotton PB. Endoscopic nasobiliary catheter drainage in biliary and pancreatic disease. Am J Gastroenterol 1991;86:389–394

    PubMed  CAS  Google Scholar 

  43. Siegel JH, Yatto RP. Biliary endoprostheses for the management of retained common bile duct stones. Am J Gastroenterol 1984;79:50–54

    PubMed  CAS  Google Scholar 

  44. Kasmin FE, Aviles L, Cohen SA, et al. Comparison of early complications of Wallstent placement vs plastic stent placement for malignancy [Abstract]. Am J Gastroenterol 1993;88:1534

    Google Scholar 

  45. Siegel JH, Ben-Zvi JS, Pullano WE. Mechanical lithotripsy of common bile duct stones. Gastrointest Endosc 1990;36:351–3565

    Article  PubMed  CAS  Google Scholar 

  46. Davids PHP, Gruen AK, Rauws EAJ, et al. Randomised trial of self-expanding metal stents vs. polyethylene stents for distal malignant biliary obstruction. Lancet 1992;340:1488–1492

    Article  PubMed  CAS  Google Scholar 

  47. Halter F, Bangerter U, Gigon GP, et al. Gallstone ileus after endoscopic sphincterotomy. Endoscopy 1981;13:88–89

    Article  PubMed  CAS  Google Scholar 

  48. Kozarek RA. Pancreatic stents can induce ductal changes consistent with chronic pancreatitis. Gastroinest Endosc 1990;36:93–95

    Article  CAS  Google Scholar 

  49. Siegel JH, Veerappan A. Endoscopic management of pancreatic disorders: potential risks of pancreatic prostheses. Endoscopy 1991;23:177–180

    Article  PubMed  CAS  Google Scholar 

  50. Smith M, Ikenberry S, Uzer M, et al. Alterations in pancreatic ductal morphology following pancreatic stent therapy [Abstract]. Gastrointest Endosc 1993;39:332

    Article  Google Scholar 

  51. Johanson JF, Schmalz MJ, Geenen JE. Incidence and risk factors for biliary and pancreatic stent migration. Gastrointest Endosc 1992;38:314–346

    Article  Google Scholar 

  52. Meyers MA. Acute extraperitoneal infection. Semin Roentgenol 1973;8:445–464

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Beth Israel Medical Center North Division, 170 East End Avenue at 87th Street, 10128, New York, NY, USA

    S. A. Cohen, J. H. Siegel & F. E. Kasmin

Authors
  1. S. A. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. H. Siegel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. E. Kasmin
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cohen, S.A., Siegel, J.H. & Kasmin, F.E. Complications of diagnostic and therapeutic ERCP. Abdom Imaging 21, 385–394 (1996). https://doi.org/10.1007/s002619900089

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s002619900089

Keywords

Search

Navigation