For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
36
views
39
references
 Top references
cited by
20
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      425
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prevention and Management of Post-Endoscopic Retrograde Cholangiopancreatography Complications

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Endoscopic retrograde cholangiopancreatography (ERCP) is associated with a spectrum of complications such as pancreatitis, hemorrhage, perforation, and cardiopulmonary events. These complications can range from mild to severe resulting in extended hospitalization, requiring surgical intervention, and leading to permanent disability or even death. Complications of ERCP have been better understood in the past decade, with adoption of standardized consensus-based definitions of complications and introduction of new recommendations to minimize risks of ERCP. Adequate selection of patients undergoing ERCP, skilled operators using novel techniques and prompt identification and treatment are key to successful prevention and management.

          Related collections

          Most cited references39

          • Record: found
          • Abstract: found
          • Article: not found

          Complications of endoscopic biliary sphincterotomy.

          M L Freeman, D Nelson, S. Sherman … (1996)
          Endoscopic sphincterotomy is commonly used to remove bile-duct stones and to treat other problems. We prospectively investigated risk factors for complications of this procedure and their outcomes. We studied complications that occurred within 30 days of endoscopic biliary sphincterotomy in consecutive patients treated at 17 institutions in the United States and Canada from 1992 through 1994. Of 2347 patients, 229 (9.8 percent) had a complication, including pancreatitis in 127 (5.4 percent) and hemorrhage in 48 (2.0 Percent). There were 55 deaths from all causes within 30 days; death was directly or indirectly related to the procedure in 10 cases. Of five significant risk factors for complications identified in a multivariate analysis, two were characteristics of the patients (suspected dysfunction of the sphincter of Oddi as an indication for the procedure and the presence of cirrhosis) and three were related to the endoscopic technique (difficulty in cannulating the bile duct achievement of access to the bile duct by "precut" sphincterotomy, and use of a combined percutaneous-endoscopic procedure). The overall risk of complications was not related to the patient's age, the number of coexisting illnesses, or the diameter of the bile duct. The rate of complications was highest when the indication for the procedure was suspected dysfunction of the sphincter of Oddi (21.7 percent) and lowest when the indication was removal of bile-duct stones within 30 days of laparoscopic cholecystectomy (4.9 percent). As compared with those who performed fewer procedures, endoscopists who performed more than one sphincterotomy per week had lower rates of all complications (8.4 percent vs. 11.1 percent, P=0.03) and severe complications (0.9 percent vs. 2.3 percent, P=0.01). The rate of complications after endoscopic biliary sphincterotomy can vary widely in different circumstances and is primarily related to the indication for the procedure and to endoscopic technique, rather than to the age or general medical condition of the patients.
          Article 0 comments Cited 410 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Incidence rates of post-ERCP complications: a systematic survey of prospective studies.

            Angelo Andriulli, Silvano Loperfido, Grazia Napolitano … (2007)
            To provide health-care providers, patients, and physicians with an exhaustive assessment of prospective studies on rates of complications and fatalities associated with endoscopic retrograde cholangiopancreatography (ERCP). We searched MEDLINE (1977-2006) for prospective surveys on adult patients undergoing ERCP. "Grey literature" was sought by looking at cited references to identify further relevant studies. Data on postprocedural pancreatitis, bleeding, infections, perforations, and miscellaneous events as well as their associated fatalities were extracted independently by two reviewers. Sensitivity analysis was performed to test for data consistency between multicenter versus single center studies, and old (1977-1996) versus recent (1997-2005) reports. In 21 selected surveys, involving 16,855 patients, ERCP-attributable complications totaled 1,154 (6.85%, CI 6.46-7.24%), with 55 fatalities (0.33%, CI 0.24-0.42%). Mild-to-moderate events occurred in 872 patients (5.17%, CI 4.83-5.51%), and severe events in 282 (1.67%, CI 1.47-1.87%). Pancreatitis occurred in 585 subjects (3.47%, CI 3.19-3.75%), infections in 242 (1.44%, CI 1.26-1.62%), bleeding in 226 (1.34%, CI 1.16-1.52%), and perforations in 101 (0.60%, CI 0.48-0.72%). Cardiovascular and/or analgesia-related complications amounted to 173 (1.33%, CI 1.13-1.53%), with 9 fatalities (0.07%, CI 0.02-0.12%). As compared with old reports, morbidity rates increased significantly in most recent studies: 6.27%versus 7.51% (P(c)= 0.029). 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.
            Article 0 comments Cited 311 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Endoscopic sphincterotomy complications and their management: an attempt at consensus.

              P Cotton, G Lehman, J. Vennes … (1991)
              Despite its relative safety (in comparison with surgery), and undoubted role in many clinical circumstances, biliary sphincterotomy is the most dangerous procedure routinely performed by endoscopists. Complications occur in about 10% of patients; 2 to 3% have a prolonged hospital stay, with a risk of dying. This document is an attempt to provide guidelines for prevention and management of complications, based on a workshop of selected experts, and a comprehensive review of the literature. We emphasize particularly the importance of specialist training, disinfection, drainage, and collaboration with surgical colleagues.
              Article 0 comments Cited 303 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Endosc
                Journal ID (iso-abbrev): Clin Endosc
                Journal ID (publisher-id): CE
                Title: Clinical Endoscopy
                Publisher: The Korean Society of Gastrointestinal Endoscopy
                ISSN (Print): 2234-2400
                ISSN (Electronic): 2234-2443
                Publication date (Print): September 2012
                Publication date (Electronic): 22 August 2012
                Volume: 45
                Issue: 3
                Pages: 305-312
                Affiliations
                [1 ]Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
                [2 ]Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical School, Minneapolis, MN, USA.
                Author notes
                Correspondence: Michel Kahaleh. Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY 10021, USA. Tel: +1-646-962-4000, Fax: +1-646-962-0110, mkahaleh@ 123456gmail.com
                Article
                DOI: 10.5946/ce.2012.45.3.305
                PMC ID: 3429758
                PubMed ID: 22977824
                SO-VID: daa2f867-6f48-44ed-8713-bbd85f60bfbf
                Copyright © Copyright © 2012 Korean Society of Gastrointestinal Endoscopy
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 June 2012
                Date revision received : 20 July 2012
                Date accepted : 20 July 2012
                Categories
                Subject: Special Issue Articles of IDEN 2012
                Subject: Session III - Pancreatobiliary

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: pancreatitis,prevention,endoscopic retrograde cholangiopancreatography
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: pancreatitis, prevention, endoscopic retrograde cholangiopancreatography

                Comments

                Comment on this article

                scite_

                Similar content425

                See all similar

                Cited by20

                See all cited by

                Most referenced authors585

                See all reference authors