A SURGICALLY-COMPROMISED SITUATION: ERCP-RELATED COMPLICATIONS

Year 2018, Volume: 51 Issue: 1, 14 - 19, 30.03.2018

Aziz Mutlu Barlas

Abstract

Background: In this retrospective study, an evaluation was made
of ERCP-related perforations and necrotizing pancreatitis that required
surgical intervention.

Methods:
A total of 1439
ERCP procedures were performed by gastroenterologists and 12 complications that
required surgical intervention were identified (0.8%). All of the
cases presented in this study were primarily managed conservatively in the Gastroenterology
Department and were evaluated by the surgeons when signs and symptoms
deteriorated.

Results: Patient age was
mean 55.5±17.3 years. The mean
time from ERCP to surgery was 3.92 days (0-14 days). Of the 12 patients, 6 (50%)
died postoperatively. No statistically significant difference was determined between
the surviving and not surviving groups in respect of patient age or the mean
time from ERCP to operation. The operational technique was decided during the
surgery depending on the extent of the perforation and the condition of the
peritoneum. The correlation between diagnosis and type of operative procedure was
similar in both groups.

Conclusions: There is no consensus on the surgical management of
ERCP-related complications which might result in high mortality rates despite
full-care management. Therefore, the main objective of departments dealing with
ERCP procedures should be to reduce the risk of ERCP-related complications to a
minimum.

Keywords

ERCP; complication; hepatobiliary surgery; perforation; necrotizing pancreatitis; duodenum

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