Complications of endoscopic retrograde cholangiopancreatography in jaundiced and cholestatic patients.
The purpose of this prospective study was to investigate the complication rate of endoscopic retrograde cholangiopancreatography (ERCP) in the management of jaundiced and unjaundiced patients with laboratory findings suggesting cholestasis. ERCP was performed in 144 jaundiced patients and in 27 patients with unjaundiced cholestasis (age range 18-89 years, mean 66 years). Endoscopic papillotomy was performed in 45 patients, three for spasm of the sphincter of Oddi and the rest for choledochal stones. Seven bile duct prostheses were inserted endoscopically, all for treatment of malignant obstruction. The complications of ERCP were as follows: four cases of pancreatitis (2.3%), five cases of cholangitis (2.9%), two cases of bleeding (1.2%) and two perforations (1.2%). The overall complication rate was thus 7.6% (13/171) and there was no primary mortality. ERCP seems to be a safe and effective method in the diagnostic study and management of bile duct obstruction even in the elderly patients with jaundice or unjaundiced cholestasis.
Pasanen
P
P
Department of Surgery, University Hospital, Kuopio, Finland.
Partanen
K
K
Pikkarainen
P
P
Alhava
E
E
Pirinen
A
A
Janatuinen
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010186:Pancreatic Function Tests; D010195:Pancreatitis / Q000209:etiology*; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology*