Endoscopy 2020; 52(S 01): S297-S298
DOI: 10.1055/s-0040-1704948
ESGE Days 2020 ePoster presentations
Colon and rectum 09:00–17:00 Thursday, April 23, 2020 ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

TREATMENT STRATEGY OF POST-ERCP COMPLICATIONS

S Budzinskiy
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
E Fedorov
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
S Shapovalianz
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
P Cherniakevich
2   Moscow University Hospital #31, Moscow, Russian Federation
,
M Zakharova
3   Vishnevsky National Мedical Research Center of Surgery, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

 

Aims To analyze the results in treatment of post-ERCP complications.

Methods The retrospective study was held at the Pirogov Russian Medical University. The complications of endoscopic transpapillary interventions occurred at the Moscow City Hospital #31, Moscow, Russian federation, from January 1st 2008 to November 1st 2019 were retrospectively evaluated.

There were 6257 endoscopic transpapillary interventions performed at the hospital. The morbidity rate was 1,5% (93), mortality rate – 0,22% (14). There were 16 (0,26%) cases of post-endoscopic papillotomy (EPT) bleeding, 52 (0,83%) cases of post-ERCP pancreatitis (PEP) and 25 (0,4%) cases of retroduodenal perforation.

Results Combined endoscopic hemostasis included epinephrine infiltration of the EPT margins and focal electrocoagulation of bleeding source in all 16 cases of post-EPT bleeding.

Pancreatic duct stenting was performed in 31 (59,6%) cases with technical success in 29 (93,5%) cases and clinical success in 28 (96,5%) cases. We reported 1 (3,5%) observation of PEP progression after stenting that lead to death. The mortality rate in non-stenting group was 23,8% (5/21).

An endoscopic treatment of ERCP-perforation was performed in 17 (68%) of 25 cases with success in 16 (94,1%) cases and mortality rate 5,9%. None of conservatively treated patients died (3 patients), while the mortality rate in surgically treated group after ERCP-perforation was 80% (4/5). So, the mortality rate in the group after ERCP-perforation was 24% (6/25).

Conclusions Treatment of patients with post-ERCP complication is a challenge. It is absolutely essential to remember about all possible risk factors, strictly follow the indications for ERCP, and clearly perform the technique of procedure to reduce the morbidity rate. We are stuck to the opinion that it is important to eliminate the post-ERCP complications endoscopically, because surgical treatment has a higher postoperative mortality rate and increases the duration and cost of treatment.