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Incidence Rates Of Post-ERCP Complications: A Systematic Survey Of Prospective Studies

A. Andriulli, S. Loperfido, G. Napolitano, G. Niro, M. R. Valvano, F. Spirito, A. Pilotto, R. Forlano
Published 2007 · Medicine

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OBJECTIVES:To provide health-care providers, patients, and physicians with an exhaustive assessment of prospective studies on rates of complications and fatalities associated with endoscopic retrograde cholangiopancreatography (ERCP).METHODS:We searched MEDLINE (1977–2006) for prospective surveys on adult patients undergoing ERCP. “Grey literature” was sought by looking at cited references to identify further relevant studies. Data on postprocedural pancreatitis, bleeding, infections, perforations, and miscellaneous events as well as their associated fatalities were extracted independently by two reviewers. Sensitivity analysis was performed to test for data consistency between multicenter versus single center studies, and old (1977–1996) versus recent (1997–2005) reports.RESULTS:In 21 selected surveys, involving 16,855 patients, ERCP-attributable complications totaled 1,154 (6.85%, CI 6.46–7.24%), with 55 fatalities (0.33%, CI 0.24–0.42%). Mild-to-moderate events occurred in 872 patients (5.17%, CI 4.83–5.51%), and severe events in 282 (1.67%, CI 1.47–1.87%). Pancreatitis occurred in 585 subjects (3.47%, CI 3.19–3.75%), infections in 242 (1.44%, CI 1.26–1.62%), bleeding in 226 (1.34%, CI 1.16–1.52%), and perforations in 101 (0.60%, CI 0.48–0.72%). Cardiovascular and/or analgesia-related complications amounted to 173 (1.33%, CI 1.13–1.53%), with 9 fatalities (0.07%, CI 0.02–0.12%). As compared with old reports, morbidity rates increased significantly in most recent studies: 6.27% versus 7.51% (Pc = 0.029).CONCLUSIONS:ERCP remains the endoscopic procedure that carries a high risk for morbidity and mortality. Complications continue to occur at a relatively consistent rate. The majority of events are of mild-to-moderate severity.
This paper references
Endoscopic retrograde cholangiopancreatography in the elderly: a prospective and comparative study.
S. Köklü (2005)
Complications of ERCP.
J. Mallery (2003)
Post-ERCP pancreatitis and hyperamylasemia: patient-related and operative risk factors.
E. Christoforidis (2002)
Prospective randomized double - blind placebo - controlled trial of glyceryl trinitrate in endoscopic retrograde cholangiopancreato - graphy - induced pancreatitis
S Sudhindran (2001)
A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy
Steven L Zacks (2002)
Prospective evaluation of complications in outpatient GI endoscopy: a survey among German gastroenterologists.
A. Sieg (2001)
Outcome and early complications of ERCP: a prospective single center study.
A. Suissa (2005)
ERCP‐ and Endoscopic Sphincterotomy‐Induced Pancreatitis
S. Sherman (1991)
Suggested standards for monitoring performance
A R Tanner (1996)
Complications of endoscopic retrograde cholangiopancreatography.
D. Lal (2003)
Complications of endoscopic sphincterotomy: results from a single tertiary referral center.
M. Barthet (2002)
Nifedipine for prevention of post-ERCP pancreatitis: a prospective, double-blind randomized study.
F. Prat (2002)
Post-ERCP pancreatitis and hyperamylasemia: The role of operative and patient
RJ Dickinson (1998)
Endoscopic papillotomy for common bile duct stones: factors influencing the complication rate.
J. Boender (1994)
ERCP and endoscopic biliary sphincterotomy-induced pancreatitis
S Gottlieb (1998)
Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.
J. Deviére (2001)
Analysis of 59 ERCP lawsuits; mainly about indications.
P. Cotton (2006)
Does prophylactic pancreatic stent placement reduce the risk of post-ERCP acute pancreatitis? A meta-analysis of controlled trials.
P. Singh (2004)
Successes, failures, early complications and their management following endoscopic sphincterotomy: Results in 394 consecutive patients from a single centre
T. Leese (1985)
Prevention of post-ERCP pancreatitis: a comprehensive review.
M. Freeman (2004)
Complications of endoscopic biliary sphincterotomy.
Z. Tulassay (1997)
Analysis of the risk factors associated with endoscopic sphincterotomy techniques: preliminary results of a prospective study, with emphasis on the reduced risk of acute pancreatitis with low-dose anticoagulation treatment.
T. Rabenstein (2000)
What are the risks of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography?
G. Tzovaras (2000)
Complications of endoscopic retrograde cholangiography in the post-MRCP era: a tertiary center experience.
Tze-Zen Ong (2005)
Complications of endoscopic sphincterotomy: Results form a single tertiary referral center. Endoscopy 2002;34:991–7
M Barthet (2002)
Complications of ERCP.
Michelle A. Anderson (2012)
Toward improving outcomes of ERCP.
M. Freeman (1998)
Success of ERCP at a referral center after a previously unsuccessful attempt.
C. P. Choudari (2000)
Antisecretory vs. antiproteasic drugs in the prevention of post-ERCP pancreatitis: the evidence-based medicine derived from a meta-analysis study.
A. Andriulli (2003)
Endoscopic sphincterotomy-induced pancreatitis: increased risk associated with nondilated bile ducts and sphincter of Oddi dysfunction.
Y. Chen (1994)
Complications of diagnostic and therapeutic ERCP: a prospective multicenter study
E. Masci (2001)
Prospective randomized double‐blind placebo‐controlled trial of glyceryl trinitrate in endoscopic retrograde cholangiopancreatography‐induced pancreatitis
S. Sudhindran (2001)
ERCP: present practice in a single region. Suggested standards for monitoring performance
A. R. Tanner (1996)
Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study.
S. Loperfido (1998)
Are complications of endoscopic sphincterotomy age related?
M. Thompson (1998)
Endoscopic sphincterotomy complications and their management: an attempt at consensus.
P. Cotton (1991)
High-dose allopurinol for prevention of post-ERCP pancreatitis: a prospective randomized double-blind controlled trial.
P. Katsinelos (2005)
Complications of ERCP: a prospective study.
M. Christensen (2004)
Severe and fatal complications after diagnostic and therapeutic ERCP: a prospective series of claims to insurance covering public hospitals.
R. Trap (1999)
Risk factors for complications after performance of ERCP.
J. Vandervoort (2002)
Post‐ERCP pancreatitis and hyperamylasaemia: the role of operative and patient factors
R. Dickinson (1998)
Impact of laparoscopic cholecystectomy: a population-based study
A. McMahon (2000)
Complications of endoscopic sphincterotomy. A prospective series with emphasis on the increased risk associated with sphincter of Oddi dysfunction and nondilated bile ducts.
S. Sherman (1991)
ERCP and endoscopic biliary sphincterotomy - induced pancreatitis
PB Cotton (1998)
NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy.
ERCP and biliary endoscopic sphincterotomy-induced pancreatitis.
K. Gottlieb (1998)

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Robert M. Brickley (2019)
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Y. Zhou (2019)
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N. Guda (2008)
Antibiotic prophylaxis for GI endoscopy
Endoscopic Procedures (2008)
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M. Lai (2009)
Prophylactic Octreotide Administration Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Meta-Analysis of Randomized Controlled Trials
Y. Bai (2008)
Diagnostic evaluation prior to cholecystectomy in mild-moderate acute biliary pancreatitis.
V. Neri (2009)
Comparative performance of non-contrast MRI with HASTE vs. contrast-enhanced MRI/3D-MRCP for possible choledocholithiasis in hospitalized patients
S. Kang (2016)
Two-stage vs single-stage management for concomitant gallstones and common bile duct stones.
J. Lu (2012)
Follow‐up to determine unplanned hospitalization and complications after endoscopic retrograde cholangiopancreatography
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A. Elbaih (2016)
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J. Lee (2011)
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Y. Hori (2014)
Chronic use of statins and risk of post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis.
A. Facciorusso (2020)
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