Abstract
Although 20% of patients report significant pain following endoscopic retrograde cholangiopancreatography (ERCP), the post-procedural complication rate is cited at only 5–10%. The most common significant complications presenting to the acute care setting include post-ERCP pancreatitis, cholangitis, cholecystitis, hemorrhage, and perforation. These complications are rare but can be associated with significant morbidity and mortality. Vigilance is crucial in addressing this unique patient population. The evaluation for these complications in patients who presents with pain following ERCP requires clinical gestalt, laboratory studies, imaging tests, and sometimes specialty consultation.
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References
Chandrasekhara V, Khashab MA, Muthusamy VR, Acosta RD, Agrawal D, Bruining DH, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017;85(1):32–47.
Early DS, Ben-Menachem T, Decker GA, Evans JA, Fanelli RD, Fisher DA, et al. Appropriate use of GI endoscopy. Gastrointest Endosc. 2012;75(6):1127–31.
Day LW, Lin L, Somsouk M. Adverse events in older patients undergoing ERCP: a systematic review and meta-analysis. Endosc Int Open. 2014;2(1):E28–36.
Andriulli A, Loperfido S, Napolitano G, Niro G, Valvano MR, Spirito F, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol. 2007;102(8):1781–8.
Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335(13):909–18.
Glomsaker TB, Hoff G, Kvaløy JT, Søreide K, Aabakken L, Søreide JA, et al. Patient-reported outcome measures after endoscopic retrograde cholangiopancreatography: a prospective, multicentre study. Scand J Gastroenterol. 2013;48(7):868–76.
Kochar B, Akshintala VS, Afghani E, Elmunzer BJ, Kim KJ, Lennon AM, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointest Endosc. 2015;81(1):143–9.e9.
Szary NM, Al-Kawas FH. Complications of endoscopic retrograde cholangiopancreatography: how to avoid and manage them. Gastroenterol Hepatol (N Y). 2013;9(8):496–504.
Cotton PB, Garrow DA, Gallagher J, Romagnuolo J. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc. 2009;70(1):80–8.
Wang P, Li ZS, Liu F, Ren X, Lu NH, Fan ZN, et al. Risk factors for ERCP-related complications: a prospective multicenter study. Am J Gastroenterol. 2009;104(1):31–40.
Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383–93.
Singh VK, Gardner TB, Papachristou GI, Rey-Riveiro M, Faghih M, Koutroumpakis E, et al. An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis. United European Gastroenterol J. 2017;5(4):491–8.
Freeman ML. Complications of endoscopic retrograde cholangiopancreatography: avoidance and management. Gastrointest Endosc Clin N Am. 2012;22(3):567–86.
Enns R, Eloubeidi MA, Mergener K, Jowell PS, Branch MS, Pappas TM, et al. ERCP-related perforations: risk factors and management. Endoscopy. 2002;34(4):293–8.
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Brickley, R.M., Leonard, K.V. (2019). How Do I Approach Pain After ERCP?. In: Graham, A., Carlberg, D.J. (eds) Gastrointestinal Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-319-98343-1_131
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DOI: https://doi.org/10.1007/978-3-319-98343-1_131
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