COMPLICATIONS OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

Aims To determine the incidence of ERCP complications.

Methods A descriptive retrospective study for 32 months, at the Mohammed VI Oujda University Hospital, which included 512 ERCP procedures. All the patients had an abdominal X-Ray at the end of the procedure and close clinical monitoring for 24 hours, with biological control. The diagnosis of post-ERCP acute pancreatitis has been made using the diagnostic criterias.

Results During the study period, 512 ERCPs were performed for 400 patients, there was a female predominance 62%, with an average age of patients of 64 years, the indications are dominated by lithiasis pathology 68.1%, followed by tumor pathology 23.7%. Acute pancreatitis was the most common complication in 4.9% of ERCPs with predictive factors: the pancreatic duct cannulation and/or its injection with the contrast, difficult of common biliary duct cannulation, the pancreatitis was severe in 60% and mild the in 40%. All patients had rehydration and an analgesic treatment adapted Post-ERCP cholangitis was observed in 2.5% of cases, with a good progression with antibiotics. Digestive bleeding in 1.2% of cases (n = 6) Endoscopic hemostasis in a single patient by injection and clip placement at the margins of the sphincterotomy, perforation was suspected in 8 patients (1.5%), of which 4 patients were managed surgically, on the breach was only objectified as perioperative in 2 patients. No cases of death related to ERCP.

Conclusions ERCP is an invasive technique, its complications are well known and must be systematically researched and managed early in order to improve the prognosis.