Post-Endoscopic Retrograde Cholangiopancreatography Complications at Dr. Cipto Mangunkusumo General Hospital

Abstract

Background: This study retrospectively evaluated post-endoscopic retrograde cholangiopancreatography (ERCP) complications at Cipto Mangunkusumo hospital in order to improve management of a subsequent prospective study of post-ERCP complications. Method : The indications, findings, diagnostic or therapeutic procedure, cannulation, devices used during the procedure, and complications of patients treated consecutively with ERCP between January 2004 and November 2008 were evaluated retrospectively. Results : Of 176 ERCP patients who were initially evaluated, 38% had undergone diagnostic ERCP and 62% therapeutic ERCP. The median age of the patients was 49 years (range 18–80 years); 95 (53.9%) were male. Only 54 of these 176 procedures could be evaluated for post-ERCP complications. A computed tomographic abdominal scan or magnetic resonance cholangio-pancreatography was performed in 23 (42.6%) patients and a biliary sphincterotomy in 14 (25.9%) patients. The overall complication rate was 33.3%: 14.8% after diagnostic ERCP and 18.5% after therapeutic ERCP. The complications after diagnostic ERCP were pancreatitis in 3 (15%) patients, cholangitis in 3 (15%) patients, hemorrhage in 1 (5%) patient, pancreatitis and hemorrhage in 1 (5%) patient; the complications after therapeutic ERCP were pancreatitis in 6 (17.6%) patients, cholangitis in 3 (8.8%) patients, hemorrhage in none, and concomitant pancreatitis with hemorrhage in 1 (2.9%) patient. No significant difference was observed between the complication rates and the type of ERCP performed. Conclusion : There were no differences in the complications after diagnostic and therapeutic ERCP. As our study shows the post-ERCP complication rate to be higher than those of other large retrospective and prospective studies, we must evaluate it in a prospective study. Keywords : post-ERCP, complications, therapeutic ERCP, diagnostic ERCP