Prevention and Management of Post-Endoscopic Retrograde Cholangiopancreatography Complications

Standardized definitions for complications of sphincterotomy were introduced first in 1991. 1 Severity is assessed primarily by length of hospital stay, and intervention required to treat the complications.The spectrum of outcomes encompasses failures, long-term sequelae, costs, extended hospitalization, and patient satisfaction.Complication rates of endoscopic retrograde cholangiopancreatography (ERCP) vary widely, even between apparently similar prospective studies.Variation is substantial.For example, in one large prospective study, post-ERCP pancreatitis rates were reported at 0.74% for diagnostic ERCP, and 1.4% for therapeutic ERCP respectively; 2 in another similar study, post procedure pancreatitis rates were 5.1% (7 fold higher) for diagnostic ERCP and 6.9% (5 fold higher) for therapeutic ER-CP.3 Possible reasons for such wide variation in reported complication rates include variation in 1) definitions; 2) thorough-