ERCP Side Effects

ERCP Side Effects
Endoscopic retrograde cholangiopancreatography, also known as an ERCP procedure, can diagnose and treat an assortment of medical concerns within the gallbladder, liver, and pancreas. However, ERCP side effects are common and can range from mild to severe. Pancreatitis after ERCP is especially common. Read more about ERCP risk factors that increase the chances of complications after ERCP procedures.
An endoscopic retrograde cholangiopancreatography (ERCP) procedure can be used to diagnose and to treat problems with the liver, pancreas, and gallbladder. Specifically, an ERCP focuses on the ducts that drain the liver and pancreas. ERCP side effects are common. Though ERCP procedures allow doctors to treat a condition at the same time it is diagnosed, the potential ERCP complications may not always be worth the risk.

Complications after ERCP

Many patients experience ERCP side effects and health complications following their ERCP procedure. According to the American Society for Gastrointestinal Endoscopy, roughly 75% of all ERCP patients experience an increase in pancreatic enzymes after an ERCP procedure. While ERCP side effects such as the increase in pancreatic enzymes are common, they do not necessarily constitute a life-threatening condition.

Pancreatitis after ERCP

The American Society for Gastrointestinal Endoscopy, or ASGE, identifies pancreatitis after ERCP as a 3-fold increase in pancreatic enzymes for more than 24 hours after an ERCP procedure. The ASGE estimates that approximately 1.6% to 15.7% of patients experience pancreatitis after ERCP, depending on the patients’ ERCP risk factors. This severe ERCP side effect is typically accompanied by new or worsening abdominal pain and requires a hospital stay of at least 2 days.

Other ERCP side effects and complications include:

  • Hemorrhage, or post ERCP bleeding.

  • Intestinal perforation.

  • Post ERCP cholangitis, which is a type of infection.

  • Post ERCP cholecystitis, which is also a type of infection.

  • Cardiopulmonary complications after ERCP.

  • Mortality, which is twice as common after a therapeutic ERCP procedure than it is after a diagnostic ERCP procedure.


ERCP Risk Factors

Certain factors affect whether an ERCP procedure is likely to cause severe side effects. As stated, ERCP procedures can cause a wide range of side effects. Some ERCP side effects are very mild, while others require additional surgery and the use of antibiotic medication.

The following is a list of ERCP risk factors that may influence the severity of ERCP side effects:

  • Personal attributes, such as age or sex. Young age may increase the risk of ERCP side effects.

  • A documented history of post ERCP pancreatitis, also known as PEP, will increase the risk of pancreatitis as an ERCP side effect.

  • Level of endoscopist experience can affect the outcome of an ERCP procedure.

  • Balloon dilation of biliary sphincter may increase ERCP health risks.

  • Levels of normal bilirubin, which is a substance produced by the liver and found in bile.

  • A precut sphincterotomy will increase the chances and severity of ERCP side effects.

  • A pancreatic duct injection will increase the risks of an ERCP procedure.

  • A pancreatic sphincterotomy also increases the risks of an ERCP procedure.

  • If the patient has suspected sphincter of Oddi dysfunction, also known as SOD, the risk of post ERCP pancreatitis doubles.


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