title: Experience on endoscopic retrograde cholangiopancreatography at tertiary referral center in Thailand: risks and complications.
abstract: BACKGROUND
  Several complications from ERCP have been described, including pancreatitis, hemorrhage, perforation, and cholangitis. The actual incidences and risk factors in Thailand have never been analyzed.
  
  
  METHODS
  The authors retrospectively reviewed the outcome of ERCP at Chulalongkorn University Hospital between September 2000 and December 2002. Potential risk factors were statistically assessed.
  
  
  RESULTS
  The incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 3.6%, 2.1%, 1.2% and 6%, respectively. Risk factors of pancreatitis were the suspected diagnosis of sphincter of Oddi dysfunction and pancreatic interventions, especially through minor papilla. Prophylactic pancreatic duct stent prior to precut sphincterotomy may reduce the incidence of pancreatitis. Hemorrhage was associated with duodenal diverticulum. The incidence of cholangitis was higher in biliary duct dilation and cholangiocarcinoma, especially hilar involvement.
  
  
  CONCLUSIONS
  Incidence of these complications was comparable to international series with similar risk factors. Cholangitis developed more frequently probably due to a higher incidence of cholangiocarcinoma.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Jacksonville, USA.
authors.forename: Surakit
authors.initials: S
authors.lastname: Pungpapong
authors.forename: Pradermchai
authors.initials: P
authors.lastname: Kongkam
authors.forename: Rungsun
authors.initials: R
authors.lastname: Rerknimitr
authors.forename: Pinit
authors.initials: P
authors.lastname: Kullavanijaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology