Surgical management of ERCP-related complications

Aim The aim of this study was to analyze clinical findings and treatment outcomes of patients with endoscopic retrograde cholangiopancreatography complications. Background Endoscopic retrograde cholangiopancreatography has become a very common procedure for the evaluation and treatment of biliary and pancreatic diseases. Patients and methods A retrospective review of 2447 endoscopic retrograde cholangiopancreatography procedures and their complications since Apr 2006 till Dec 2010 was conducted to identify their incidence, optimal management, and clinical outcomes. Results 2447 endoscopic retrograde cholangiopancreatography procedures were performed. Overall, complications developed in 168 (6.9%) cases: perforation in 10 (0.4%), hemorrhage in 4 (0.16%) and mild to severe pancreatitis in 154 (6.3%). The patients mean age was 66± 6 yrs with females/ males of 1432(58.5%)/ 1015(41.5%). Abdominal pain, nausea, leukocytosis and hyperamylasemia were most common findings in these patients. Surgery was performed for 6 patients (0.24%). The most hospital station was 20 days: surgical group 7±2 days, pancreatitis 11± 4 days and average 6 days for others. Conclusion Endoscopic retrograde cholangiopancreatography remains the endoscopic procedure that carries a high risk for morbidity and or mortality. The majority of events are of mild-to-moderate severity and when surgery should be done, it depends upon the clinicopathological condition and we don't advise pyloric exclusion, gastrojejunostomy and duodenal diversion for these patients.