Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography

Bang, Ji Young; Coté, Gregory A.

doi:10.1016/j.tgie.2014.07.007

Cited by 7 publications

(6 citation statements)

References 90 publications

(174 reference statements)

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“…Although there are efforts to standardize the methods of reporting cardiopulmonary AEs with endoscopy, the number of studies including these definitions is small [ 21 ]. Publications indicating that cardiopulmonary complications are between 4% and 16% according to the definitions used are available in the literature [ 22 ]. However, in studies excluding transient hypoxia and transient hypotensive states during the procedure, the rate of clinically significant cardiopulmonary AE ranges from 0.04% to 2.4% [ 16 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Adverse Events in Endoscopic Retrograde Cholangiopancreticography for Choledoccolithiasis: A Holistic Perspective

Cankurtaran,

Ersoy

2024

Cureus

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Background and aims In this study, we aimed to investigate the frequency of adverse events (AEs) in patients undergoing endoscopic retrograde cholangiopancreticography (ERCP) for choledocholithiasis and the independent risk factors that may cause these conditions. We planned to evaluate all AEs including cardiopulmonary complications and the risk factors that may affect them holistically. Methods This study was designed as a retrospective cohort study conducted at a single tertiary center's gastroenterology clinic. The study included patients with naive papillae and undergoing ERCP for choledocholithiasis between May 2019 and June 2022. Risk factors that may lead to AEs were analyzed in terms of both patient-related factors and procedure-related factors. Patients with and without AEs after ERCP were compared. Results This study included 812 patients who underwent ERCP for choledocholithiasis. AE occurred in 149 (18.3%) of patients, and the most common complication was pancreatitis (n=112, 13.8%). In regression analysis, of the patient- and procedure-related factors, only difficult cannulation was a significant independent risk factor for AEs (odds ratio=3.85, 95% CI: 1.102-13.498, p=0.035). Conclusion This study showed that, of patient- and procedure-related factors, only difficult cannulation is an independent risk factor for ERCP-related AEs.

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Section: Discussionmentioning

confidence: 99%

Adverse Events in Endoscopic Retrograde Cholangiopancreticography for Choledoccolithiasis: A Holistic Perspective

Cankurtaran,

Ersoy

2024

Cureus

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“…De lo revisado en la literatura, la mayoría de los pacientes son mujeres, con una mediana de edad de 59 años; la gran mayoría de los pacientes presentan síntomas en las primeras 24 horas pos-CPRE, al igual que el caso descrito (7).…”

Section: Discussionunclassified

“…En cuanto a la causalidad, se describen múltiples teorías, como la punción accidental del árbol biliar con ruptura de los vasos del parénquima hepático o la fuerza excesiva en la tracción para la extracción de los cálculos (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Discussionunclassified

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Hematoma subcapsular hepático post – CPRE: reporte de caso y revisión de la literatura

Rey¹,

Benítez

Gutiérrez

et al. 2021

Rev colomb Gastroenterol

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Presentamos el caso de un paciente de 68 años, sin antecedentes de importancia, que por su cuadro clínico y resultados paraclínicos fue clasificado con riesgo intermedio para coledocolitiasis. En efecto, por medio de colangiorresonancia se realizó el diagnóstico confirmatorio. Fue llevado a colangiopancreatografía retrograda endoscópica en dos ocasiones –la primera fallida por papila intradiverticular–; en el segundo intento (exitoso con extracción del lito), el paciente presentó evolución posprocedimiento tórpida, con marcado dolor abdominal y anemización. Fue llevado a tomografía de abdomen con contraste, la cual confirmó el diagnóstico de hematoma subcapsular. Se decidió implementar el manejo conservador y se logró un control adecuado del sangrado.

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“…While post-ERCP pancreatitis, bleeding, perforation, and infectious adverse events are amongst the most common, cardiopulmonary adverse events should not be considered negligible, accounting for 4–16% of ERCP-related adverse events. Amongst the latter, air embolism, although rare, is a potentially devastating adverse event [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography

Ekmektzoglou

Alexandrakis²,

Dimopoulos³

et al. 2021

Case Rep Gastroenterol

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Air embolism (a result of direct communication with the vasculature and an external pressure gradient from the gastrointestinal or the biliary tract), although rare, is a potentially devastating adverse event seen in endoscopic retrograde cholangiopancreatography (ERCP) procedures. Whether venous, arterial, or paradoxical, the clinical presentation ranges from asymptomatic patients to cardiorespiratory arrest. This is of particular importance because it makes the diagnosis of air embolism even more difficult in an already sedated patient. Since early recognition increases the chances of patients’ survival, endoscopists should be highly motivated and trained to recognize this complication as early as possible. With only 60 cases of air embolism reported (and even fewer related to paradoxical air embolism), we aimed to report a case of paradoxical cerebral air embolism in a patient undergoing ERCP due to a common bile duct stricture and to provide a mini-review of this clinical entity that can serve as a bedside quick reference guide for endoscopists worldwide.

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Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography

Cited by 7 publications

References 90 publications

Adverse Events in Endoscopic Retrograde Cholangiopancreticography for Choledoccolithiasis: A Holistic Perspective

Adverse Events in Endoscopic Retrograde Cholangiopancreticography for Choledoccolithiasis: A Holistic Perspective

Hematoma subcapsular hepático post – CPRE: reporte de caso y revisión de la literatura

When in Trouble Think of the Bubble: Paradoxical Cerebral Arterial Gas Embolism after Endoscopic Retrograde Cholangiopancreatography

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