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News

Complications of ERCP: a prospective study

A recent study in November's Gastrointestinal Endoscopy confirms that the complication rate of ERCP including therapeutic procedures is high, whilst cardiopulmonary complications are not as common as expected.

News image

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Background Studies of ERCP-related morbidity seldom include a sufficient patient follow-up.

Dr Christensen and colleagues from Denmark designed a study in order to characterize and to evaluate the frequency of complications, cardiopulmonary untoward events in particular.

The researchers included all patients undergoing ERCP during a 2-year period in this prospective study.

The research team assessed any complications at the time of ERCP and by postal/telephone contact at 30-days after the procedure.

The study included a total of 1177 ERCPs in the analysis, of which 56.2% were therapeutic.

The researchers found that the 30-day complication rate was 15.9%; the procedure-related mortality rate was 1.0%.

In addition, the research team noted that post-ERCP pancreatitis occurred in 3.8% of patients (3 deaths).

Cholangitis occurred in relation to 5% of the ERCP procedures
Gastrointestinal Endoscopy

The researchers found that hemorrhage or perforation occurred with 0.9% and 1.1%, respectively, of the procedures (3 deaths).

One perforation that resulted in the death of the patient occurred after placement of an endoprosthesis.

Cholangitis was found to have occurred in relation to 5% of the ERCP procedures (3 deaths).

Cardiorespiratory complications occurred in 2.3% (2 deaths).

The research team used multivariate analysis to show that dilated bile duct, placement of stent, and use of more than 40 mg of hyoscine-N-butyl bromide were risk factors for complications.

The researchers showed that the risk of pancreatitis was increased with age under 40 years, placement of stent, and a dilated bile duct.

Dr Christensen concluded, "This prospective study confirms that the complication rate of ERCP including therapeutic procedures is high."

"Cardiopulmonary complications were not as common as expected, despite being the special focus of the study."

Gastrointestinal Endoscopy; 2004: 60 (5) : 721
30 November 2004

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