November 12, 2014
Notes: Hu, Wenyan
Research Support, Non-U.S. Gov’t
J Biomed Opt. 2013 May;18(5):56002. doi: 10.1117/1.JBO.18.5.056002.
Author Address: Huazhong University of Science and Technology, Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Wuhan 430074, China.
Reference Type: Journal Article
Record Number: 5314Author: Iorgulescu, A., Sandu, I., Turcu, F. and Iordache, N.
Title: Post-ERCP acute pancreatitis and its risk factors
Journal: J Med Life
Date: Mar 15
Short Title: Post-ERCP acute pancreatitis and its risk factors
Alternate Journal: Journal of medicine and life
ISSN: 1844-3117 (Electronic)
Accession Number: 23599832
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects/mortality
Pancreatitis, Acute Necrotizing/*etiology
Abstract: INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex endoscopic technique that evolved from a diagnostic to a mainly therapeutic procedure. This was due to the identification of post-procedural complications that can follow both simple ERCP and that associated with the instrumentation of the biliary and pancreatic ductals. The identification of post ERCP complications in a proportion of 5 to 10% of cases, with a mortality rate of 0.33%, imposed their analysis and study of risk factors involved in their occurrence. The significance of post ERCP complications reveals the necessity of their avoidance by adopting additional measures if risk factors are identified. MATERIALS AND METHODS: We have retrospectively analyzed 900 cases that underwent ERCP in the Surgery Department of “Sf. Ioan” Clinical Hospital in a period of 17 years. The complications of the procedure were studied. Among them, a special attention was given to post-ERCP acute pancreatitis (pERCP-AP), the most common complication that occurred in the study group. We also tried to find out and highlight the risk factors for this complication. RESULTS: ERCP is a relatively safe invasive procedure, yet it has complications (8% of cases), some of them potentially fatal (mortality 0.43%). The most common complications after ERCP are acute pancreatitis (3.7%), papillary bleeding (1.04%), retroperitoneal duodenal perforation (0.69%) and biliary septic complications like acute cholecystitis and cholangitis (1.21%). Acute pancreatitis is by far the most common complication. Risk factors for its occurrence are difficult sphincterotomy with precut use, failure of CBD desobstruction, pancreatic sphincterotomy, repeated injection of contrast in the pancreatic ductal system, dysfunction of the sphincter of Oddi and the absence of changes of chronic pancreatitis. When risk factors are identified, the patients’ selection must be very strict and diagnostic ERCP should be avoided in favor of non-invasive diagnostic methods (MRI-cholangiography, echo-endoscopy).