Online citations, reference lists, and bibliographies.
← Back to Search

Post-Endoscopic Retrograde Cholangiopancreatography Infection

Ju Sang Park
Published 2017 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Infection is a known complication of endoscopic retrograde cholangiopancreatography (ERCP), occurring in up to 1.5% of cases. However, it is important to realize that true incidence may be underestimated because infection may go unnoticed. Post-ERCP infections are considered to be endogenous infections arising from the intestinal bacteria of the patient and introduction of exogenous bacteria through inadequately reprocessed duodenoscopes. During the past years, carbapenem resistance has become a major concern for public health. The infection outbreaks after ERCP are linked to breaches in adherence to disinfection manual and complex design of duodenoscopes difficult to reprocess. The most important risk factor for ERCP-related cholangitis is inadequate biliary drainage. To minimize the risk of post-ERCP infection it would be helpful that the volume of contrast injected into the biliary tree has to be minimized to obtain adequate cholangiogram. In patients with bile duct obstruction and failed drainage of infected bile via ERCP, every effort should be made to achieve prompt decompression of an obstructed biliary system. Antibiotic prophylaxis is recommended only in patients with biliary obstruction in which there is a possibility that complete drainage may not be achieved at the ERCP. Korean J Pancreas Biliary Tract 2017;22(1):24-34
This paper references
Complications after ERCP in liver transplant recipients.
D. Balderramo (2011)
Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography.
M. Brand (2010)
Antibiotics, biliary sepsis, and bile duct stones.
J. Leung (1994)
Antibiotic Post-ERCP Infection 34 prophylaxis of cholangitis complicating endoscopic treatment of biliary obstruction
J Spicak (2001)
Risk factors of post endoscopic retrograde cholangiopancreatography bacteremia. Gut Liver 2013;7:228-233
MS Kwak (2013)
Prophylactic Antibiotics Cannot Prevent Endoscopic Retrograde Cholangiopancreatography-Induced Cholangitis: A Meta-Analysis
Y. Bai (2009)
Review article: antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP)
Subhani (1999)
Incidence Rates of Post-ERCP Complications: A Systematic Survey of Prospective Studies
A. Andriulli (2007)
Infection after ERCP, and antibiotic prophylaxis: a sequential quality-improvement approach over 11 years.
P. Cotton (2008)
Prophylactic antibiotic treatment in therapeutic or complicated diagnostic ERCP: Results of a randomized controlled clinical study:
N. Na (1995)
Antibiotic prophylaxis for GI endoscopy.
S. Banerjee (2008)
Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study.
E. Williams (2007)
Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice: is it worth the cost?
B. F. Thompson (2002)
Infectious disease complications of GI endoscopy: Part I, endogenous infections.
D. Nelson (2003)
Meta-analysis of randomized trials comparing the patency of covered and uncovered self-expandable metal stents for palliation of distal malignant bile duct obstruction.
A. Saleem (2011)
Withdrawal of a novel-design duodenoscope ends outbreak of a VIM-2-producing Pseudomonas aeruginosa.
C. Verfaillie (2015)
Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography.
C. Aumeran (2010)
Cholangitis prevention in endoscopic Klatskin tumor palliation: air cholangiography technique
F. Pisello (2009)
Quality indicators, including complications, of ERCP in a community setting: a prospective study.
Joshua B Colton (2009)
Bacterial invasion of the biliary system by way of the portal‐venous system
J. Y. Sung (1991)
ERCP: Complications and prophylaxis a controlled study.
J. Brandes (1981)
Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Card
W. Wilson (2007)
Endoscopic management of acute cholecystitis after metal stent placement in patients with malignant biliary obstruction: a case series.
P. Saxena (2013)
Endoscopic sphincterotomy complications and their management: an attempt at consensus.
P. Cotton (1991)
Prevalence of clinically relevant bacteremia after upper gastrointestinal endoscopy in bone marrow transplant recipients.
J. Bianco (1990)
Pseudomonas aeruginosa and Enterobacteriaceae bacteremia after biliary endoscopy: an outbreak investigation using DNA macrorestriction analysis.
M. Struelens (1993)
Prospective assessment of the role of antibiotic prophylaxis in ERCP.
J. Llach (2006)
Effect of CO2 cholangiography on post-ERCP cholangitis in patients with unresectable malignant hilar obstruction – a prospective, randomized controlled study
R. Zhang (2013)
Antibiotic prophylaxis for infectious complications after therapeutic endoscopic retrograde cholangiopancreatography: a randomized, double-blind, placebo-controlled study.
B. Byl (1995)
The role of antibiotic prophylaxis in endoscopic retrograde cholangiopancreatography; a retrospective single-center evaluation
L. M. Kager (2012)
Complications of Endoscopic and Radiologic Investigation of Biliary Tract Disorders
K. Mergener (2011)
Air cholangiogram is not inferior to dye cholangiogram for malignant hilar biliary obstruction: A randomized study of efficacy and safety
R. Sud (2014)
Outbreak of Pseudomonas aeruginosa following endoscopic retrograde cholangiopancreatography.
J. Earnshaw (1985)
Changes in biliary bacteria after endoscopic cholangiography and sphincterotomy.
J. A. Sand (1992)
Post-ERCP pancreatitis: Reduction by routine antibiotics
S. Räty (2001)
Risk Factors of Post Endoscopic Retrograde Cholangiopancreatography Bacteremia
Min-Sun Kwak (2013)
[Antibiotic prophylaxis using cefuroxime in bile duct endoscopy].
R. Lorenz (1996)
Antibiotic prophylaxis for endoscopic retrograde chlangiopancreatography increases the detection rate of drug‐resistant bacteria in bile
T. Minami (2014)
Withdrawal of a novel-design duodenoscope ends outbreak of a VIM-2-producing Pseudomonas aeruginosa.
C. Verfaillie (2015)
Antibiotic prophylaxis for GI endoscopy.
M. Khashab (2015)
Complications of endoscopic biliary sphincterotomy.
M. Freeman (1996)
ERCP: Complications and Prophylaxis
Brandes Jw (1981)
Is it necessary to insert a nasobiliary drainage tube routinely after endoscopic clearance of the common bile duct in patients with choledocholithiasis-induced cholangitis? A prospective, randomized trial.
Jun Kyu Lee (2010)
Antibiotic prophylaxis of infectious complications with endoscopic retrograde cholangiopancreatography. A randomized controlled study.
G. Sauter (1990)
Addition of gentamicin to endoscopic retrograde cholangiopancreatography (ERCP) contrast medium towards reducing the frequency of septic complications of ERCP
F. Ramirez (2010)
The effect of adding gentamicin to contrast media for prevention of cholangitis after biliary stenting for non-calculous biliary obstruction, a randomized controlled trial
A. Norouzi (2012)
Klebsiella spp. in endoscopy-associated infections: we may only be seeing the tip of the iceberg
P. Gastmeier (2013)
New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes.
L. Epstein (2014)
Cholecystitis after metallic stent placement in patients with malignant distal biliary obstruction.
H. Isayama (2006)
Pseudomonas septicaemia after endoscopic retrograde cholangiopancreatography--an unresolved problem.
D. Bass (1990)
Meta-analysis of antibiotic prophylaxis in endoscopic retrograde cholangiopancreatography (ERCP).
A. Harris (1999)
Piperacillin To Prevent Cholangitis after Endoscopic Retrograde Cholangiopancreatography
S. J. van den Hazel (1996)
Serious Pseudomonas infections associated with endoscopic retrograde cholangiopancreatography.
D. Classen (1988)
[Clinical effects of bile aspiration just before contrast injection during endoscopic retrograde cholangiopancreatography].
J. Choi (2012)
No benefit of covered vs uncovered self-expandable metal stents in patients with malignant distal biliary obstruction: a meta-analysis.
Majid Abdulrahman Almadi (2013)

Semantic Scholar Logo Some data provided by SemanticScholar