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Endoscopic complications—avoidance and management

Nature Reviews Gastroenterology & Hepatology volume 9, pages 162–172 (2012)Cite this article

Subjects

Abstract

The frequency of endoscopic complications is likely to rise owing to the increased number of indications for therapeutic procedures and also to the increased complexity of endoscopic techniques. Informed patient consent should be obtained as part of the procedure. Prevention of endoscopic adverse events is based on knowledge of the relevant risk factors and their mechanisms of occurrence. Thus, suitable training of future gastroenterologists and endoscopists is required for these complex procedures. When facing a complication, appropriate management is generally provided by an early diagnosis followed by prompt therapeutic care tailored to the situation. The most common complications of diagnostic and therapeutic upper gastrointestinal endoscopy, retrograde cholangiopancreatography, small bowel endoscopy and colonoscopy are reviewed here. Different modalities of medical, endoscopic or surgical management are also considered.

Key Points

  • Avoiding unnecessary invasive examinations is the best way to prevent endoscopic complications

  • Correct information about the patient and informed patient consent are paramount

  • Acquiring and maintaining expertise and competency in specific procedures is essential to reduce the risk of adverse events

  • Standardized treatments, training and guidelines are required to prevent and manage adverse events

  • Assessing center-specific and operator-specific complication rates could lead to improved quality and safety of endoscopic procedures

  • The appropriate management of complications requires early diagnosis and prompt therapeutic care

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Figure 1: An algorithm for the management of upper gastrointestinal perforation.
Figure 2: An algorithm for the management of colonic perforation.
Figure 3: Endoscopic closure of colonic perforation.

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Authors and Affiliations

  1. ISPPC, 1 Boulevard Zoé Drion, 6000, Charleroi, Belgium

    Daniel Blero

  2. Gastroenterology Department, Hôpital Erasme, Université Libre de Bruxelles (ULB), 808 route de Lennik, 1070, Brussels, Belgium

    Jacques Devière

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  1. Daniel Blero
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  2. Jacques Devière
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Both authors contributed equally to all aspects of this Review.

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Correspondence to Daniel Blero.

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Blero, D., Devière, J. Endoscopic complications—avoidance and management. Nat Rev Gastroenterol Hepatol 9, 162–172 (2012). https://doi.org/10.1038/nrgastro.2012.3

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