Document Detail


Infectious complications of endoscopic retrograde cholangio-pancreatography managed in a surgical unit.
MedLine Citation:
PMID:  1478808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The immediate infectious pancreato-biliary complications of endoscopic retrograde cholangiopancreatography (ERCP) warranting transfer to a surgical unit are analyzed, in order to evaluate their frequency and severity as well as means of treatment and prevention. Thirty complications of this type were observed in a series of 3226 ERCP performed with or without endoscopic sphincterotomy (ES) over a six year period (0.9%). ES had been performed in 12 of 30 cases, but the complication could not be attributed to the procedure. Post-ERCP complications included: acute cholangitis: 16 cases (53%); acute cholecystitis: 8 cases (26%); acute pancreatitis: 4 cases (13%); infected pancreatic pseudocyst: 2 cases (6%). The global mortality rate was 16.6% (five patients): Four of the deaths were due to septic complications. Twenty-seven of the 30 patients underwent surgery, and three of them died (11%). Acute cholangitis was responsible for most of the deaths (four of five) and the mortality appeared related to the long interval before surgery (three of four deaths). Strict adherence to good endoscopic procedures (aseptic conditions, injection without excessive pressure, antibiotic prophylaxis) and decompression of the biliary tract (nasobiliary drain or transhepatic catheter) should help reduce the frequency of post-ERCP complications, and especially cholangitis, which appears to benefit from early surgical treatment.
Authors:
D Benchimol; J L Bernard; J Mouroux; R Dumas; D Elkaim; M Chazal; A Bourgeon; H Richelme
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International surgery     Volume:  77     ISSN:  0020-8868     ISO Abbreviation:  Int Surg     Publication Date:    1992 Oct-Dec
Date Detail:
Created Date:  1993-02-11     Completed Date:  1993-02-11     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0043524     Medline TA:  Int Surg     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  270-3     Citation Subset:  IM    
Affiliation:
Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, Nice, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Biliary Tract Diseases / etiology*
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
Cholangitis / etiology,  mortality
Cholecystitis / etiology
Female
France / epidemiology
Humans
Male
Middle Aged
Pancreatic Diseases / etiology*
Pancreatic Pseudocyst / etiology
Pancreatitis / etiology
Retrospective Studies
Sphincterotomy, Endoscopic
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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