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World J Meta-Anal. Jun 28, 2022; 10(3): 122-129
Published online Jun 28, 2022. doi: 10.13105/wjma.v10.i3.122
Rare post-endoscopic retrograde cholangiopancreatography complications: Can we avoid them?
Marta Aleksandra Przybysz, Rafał Stankiewicz
Marta Aleksandra Przybysz, Rafał Stankiewicz, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw 02-097, Poland
Author contributions: Przybysz MA conceptualized the study, did the literature search, wrote the paper, and approved the final version of the article; Stankiewicz R conceptualized the study, did the literature search, critically reviewed the paper, and approved the final version of the article.
Conflict-of-interest statement: All the authors declare that there are no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marta Aleksandra Przybysz, MD, Attending Doctor, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, Warsaw 02-097, Poland. martprzybysz@gmail.com
Received: March 15, 2022
Peer-review started: March 15, 2022
First decision: April 13, 2022
Revised: May 11, 2022
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: June 28, 2022
Abstract

Regarded as a minimally invasive procedure, endoscopic retrograde cholangiopancreatography (ERCP) is commonly used to manage various pancreaticobiliary disorders. The rate of complications is low and starts from 4% for diagnostic interventions. The group of most frequent negative outcomes is commonly known and includes pancreatitis, cholecystitis, and hemorrhage. Rare adverse effects occur occasionally but carry a significant risk of unexpected and potentially dangerous results. In some cases, including splenic injury, the knowledge of pre-existing conditions might be helpful in avoiding the unwanted outcome, while in others, the risk factors are not clearly defined. Such situations demand increased caution in the post-ERCP period. The appearance of abdominal pain, peritoneal symptoms, or instability of the patient’s hemodynamic condition should alert the physician and lead to further investigation of the possible causes. The diagnostic process usually involves imaging tests. The implementation of the appropriate treatment should be immediate, as many of the rare complications carry the risk of dangerous, even potentially lethal, results.

Keywords: Endoscopic retrograde cholangiopancreatography, Pancreaticobiliary disorders, Rare complications, Risk factors, Prevention

Core Tip: Endoscopic retrograde cholangiopancreatography is a common procedure used to manage pancreaticobiliary disorders. The group of most frequent complications is well described and includes pancreatitis, cholecystitis, and hemorrhage. Rare adverse effects occur occasionally but carry a significant risk of unexpected and potentially dangerous results. In some cases, the knowledge of pre-existing conditions might be helpful in avoiding the unwanted outcome, while in others, the risk factors are not clearly defined. Such situations demand increased caution in the post-procedure period. Physicians should be alerted by symptoms of abdominal pain or instability of patient’s condition, investigate further for possible causes, and be ready to implement the appropriate treatment immediately.