Results of Treatment of Post-ERCP Complications
https://doi.org/10.16931/1995-5464.2015384-93
Abstract
Aim. To evaluate retrospectively the results of post-ERCP сomplications treatment.
Material and Methods. 2688 ERCPs were performed for the period from 2008 to 2014. Bleeding, acute pancreatitis and retroduodenal perforation occurred in 5 (0.2%), 34 (1.26%) and 12 (0.45%) patients respectively.
Results. In all cases of delayed post-ERCP bleedings adequate hemostasis has been achieved by epinephrine injection into edges of dissected papilla and monopolar electrocoagulation. There were no recurrent bleeding and bleeding-related deaths. Endoscopic treatment of ERСP-associated (“retroduodenal”) perforation was applied in 6 cases and was effective in 5 cases (83.3%). Overall mortality was 25% (3 patients) including 2 after surgery and 1 after failed endoscopic treatment. Stenting of main pancreatic duct was applied in 24 cases with successful result in 22 (91.7%) patients followed by full recovery. No complications of stenting procedure were observed. In other 12 observations medical therapy and/or surgical interventions were performed with mortality rate 16.7% in this group.
Conclusion. Treatment of patients with ERCP-assotiated complications is durable, laborious and expensive process. Timely diagnosis of complications, assessment of their severity, choice of adequate curative method are very important. Anyone should keep in mind all possible risk factors, clearly define the indications for ERCP, follow the technique of procedure strictly to reduce number of complications. We believe that post-ERCP complications should be predominantly treated endoscopically because surgery leads to higher postoperative mortality and increases duration and cost of treatment.
About the Authors
S. A. BudzinskiyRussian Federation
Cand. of Med. Sci., Senior Researcher of the Research Laboratory of Surgical Gastroenterology and Endoscopy of the Chair of Hospital Surgery No 2, Medical Faculty of N.I. Pirogov Russian National Research Medical University, Senior Registrar of Endoscopy Department No 1, MCH No 31, Moscow
E. D. Fedorov
Russian Federation
Doct. of Med. Sci., Professor, Сhief Scientific Officer of the Research Laboratory of Surgical Gastroenterology and Endoscopy, N.I. Pirogov Russian National Research Medical University
G. V. Konyukhov
Russian Federation
Cand. of Med. Sci., Physician at the Department of Endoscopy No 1, MCH No 31, Moscow
A. Yu. Kotieva
Russian Federation
Graduate Student of the Department of Hospital Surgery No 2, Medical Faculty of N.I. Pirogov Russian National Research Medical University
S. G. Shapovaliyants
Russian Federation
Doct. of Med. Sci., Professor, Head of the Department of Hospital Surgery No 2, Medical Faculty of N.I. Pirogov Russian National Research Medical University
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Review
For citations:
Budzinskiy S.A., Fedorov E.D., Konyukhov G.V., Kotieva A.Yu., Shapovaliyants S.G. Results of Treatment of Post-ERCP Complications. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(3):84-93. (In Russ.) https://doi.org/10.16931/1995-5464.2015384-93