Thursday, June 3, 2010

COMPLICATIONS OF ERCP

WHAT ARE THE POSSIBLE COMPLICATIONS OF ERCP?

ERCP is generally a well-tolerated procedure when performed by specialists who have had training and experience in this technique.

Major complications requiring hospitalisation can occur but are uncommon during diagnostic ERCP. They include serious pancreatitis, infections, bowel perforation, and bleeding, with each occurring in less than 1% of patients. Another potential risk of ERCP is an adverse reaction to the anaesthetic/sedative used. The risks of the procedure vary with the indications for the test, what is found during the procedure, what therapeutic intervention is undertaken, and the presence of other major medical problems, eg. heart or lung disease. Your specialist will tell you what your likelihood of complications is before undergoing the test.

If therapeutic ERCP is performed (cutting and opening in the bile duct – “sphincterotomy”, stone removal, dilation of a stricture, stent or drain placement, etc.), the possibility of a complication is somewhat higher:

• Pancreatitis in 3-5%
• Bleeding requiring transfusion in 2-3%
• Bowel perforation in 1-2%

These risks must be balanced against the benefits of the procedure and the risks of alternative surgical treatment of the condition. Often these complications can be managed without surgery but occasionally surgery is necessary.
RESULTS
After the examination, the specialist explains the results. If the effects of the anaesthetic are prolonged, the specialist may suggest an appointment for a later date when the patient can fully understand the results.

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