Diagnosis and Management of ERCP Complications: The Results of 15000 Cases from Two Centers

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a method of diagnosing and treating pancreaticobiliary diseases. ERCP differs from other endoscopic procedures with a greater risk of developing complications. The study aims to share experiences in diagnosing and managing complications in 15000 ERCP cases performed by two general surgeons in two separate general surgery ERCP units in 13 years and to determine appropriate diagnosis and treatment approaches in patients with complications. Materials and Methods: This study retrospectively evaluated the data of 15000 patients who underwent ERCP with various diagnoses between June 2009 and June 2022 in General Surgery Clinics in two different centers. Age, sex, ERCP indications, comorbidity, and clinical findings of the patients were recorded. Results: All patients who underwent ERCP were divided into two groups according to the incidence of complications. The patients who developed complications had higher ages, hospitalization days, and intensive care unit admission rates. Comorbidity increased the rate of complication development: amylasemia and acute pancreatitis were the most developed complications, respectively. Women developed more post-ERCP pancreatitis (PEP). Pre-incision, the number of ERCPs applied was not found to affect PEP development. Choledochal stone was the most important indication for ERCP in patients who developed PEP. Conclusion: ERCP is an invasive procedure, and complications such as acute pancreatitis, hemorrhage, perforation, cholangitis, and cholecystitis develop after this procedure. Determining these complications and related risk factors will be beneficial in terms of patient satisfaction and health expenditures.