Essay On Erp

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Overall complication rates: The overall complication rates of ERCP in published trails vary from 4% to 15.9% with procedure-related mortality ranging from 0% to 1%. (Cheng et al., 2006). The incidence of major complications is ranging from 4% to 5%. Comparison of complication rates a mong trials can be difficult because of heterogeneity in study design and among study populations. Even in the more recent rails, which attempt to use consensus definitions of complications, there is significant variability in reported complication rates a nd associated risk factors (Jeremy, 2008). Higher short-term complication rates are not associated with increasing American Society of Anesthesiologist (ASA) score and ERCP is safely performed in elderly …show more content…

Bleeding may complicate ES in as many as 2% to 12% of cases. Although this usually manifests immediately and intraprocedurally, bleeding can be delayed by hours to days. Risk factors for post-ES bleeding may include coagulopathy or recent anticoagulation, cholangitis, cirrhosis, periampullary diverticulum, stone impaction and ampullary tumor. Treatment options for post-ES bleeding include conservative supportive measures, endoscopic hemost asis, angiographic embolization and surgery (Janak et al ,2010). (2) Perforation; ERCP-related perforation occurs in 0.1 -1.8% of patients after therapeutic ERCP. It is a serious complication with a high mortality rates. Delayed diagnosis and intervention are associated with a high mortality. Death following ERCP-related perforation is usually related to sepsis and multi-organ dysfunction. The presence of duodenal perforation in a patient with coexisting sepsis due to cholangitis or pancreatitis further increases the management difficulty (Lau and Eric, 2008). ERCP-associated perforations of the esophagus, stomach or duodenum distant from the ampulla are all caused by the endoscope. Peri-ampullary retroperitoneal perforations usually are caused by ES or result from bile duct injuries related to instrumentation with a wire or basket (Suissa et al, 2005). Perforations can be classified into four types: Type I: lateral or medial duodenal wall perforation, Type II: peri- Vaterian injuries, Type

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