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Endoscopic retrograde cholangiopancreaticography-related complications – Experience from tertiary care teaching centre over half a decade
Amol Sonyabapu Dahale1, Manish Gupta2, Pritul Saxena2, Ajay Kumar2, Ujjwal Sonika2, Manish Kumar2, Siddharth Srivastava2, Sanjeev Sachdeva2, Barjesh Chander Sharma2, Amarender Singh Puri2, Ashok Dalal2
1 Department of Gastroenterology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
2 Department of Gastroenterology, G. B Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Correspondence Address:
Ashok Dalal,
Department of Gastroenterology, Academic Block, GB Pant Hospital, 1, JLN Marg, New Delhi - 110 002
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmas.jmas_272_21 PMID: 35046182
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Introduction: Endoscopic retrograde cholangiopancreaticography (ERCP) is an essential therapeutic procedure with a significant risk of complications. Data regarding the complications and predictors of adverse outcomes such as mortality are scarce, especially from India and Asia. We aimed to look at the incidence and outcome of complications in ERCP patients.
Materials and Methods: This study is a retrospective analysis of prospectively collected data of all the patients who underwent ERCP and had a complication from January 2012 to December 2018. Data were recorded in predesigned pro forma. The data analysis was done by appropriate statistical tests.
Results: A total of 17,163 ERCP were done. A total of 570 patients (3.3%) had complications; perforation (n = 275, 1.6%) was most common followed by pancreatitis (n = 177, 1.03%) and bleeding (n = 60, 0.35%). The majorities of perforations were managed conservatively (n = 205, 74.5%), and 53 (19%) required surgery. Overall, 69 (0.4%) patients died. Of these, 30 (10.9%) patients died with perforation. Age (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.005–1.07) and need of surgery (OR: 5.11, 95% CI: 1.66–15.77) were the predictors of mortality in patients with perforation. The majority pancreatitis were mild (n = 125, 70.6%) and overall mortality was 5.6% (n = 10).
Conclusion: ERCP complications have been remained static over the years, with perforation and pancreatitis contributing the most. Most perforations can be managed conservatively with good clinical outcomes.
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