Endoscopic Retrograde Cholangiopancreatography-Related Complications and Their Management Strategies: A “Scoping” Literature Review

  • Kemmian D. Johnson
  • Abhilash Perisetti
  • Benjamin Tharian
  • Ragesh Thandassery
  • Priya Jamidar
  • Hemant GoyalEmail author
  • Sumant Inamdar
Mentored Review


Endoscopic retrograde cholangiopancreatography (ERCP) is a well-known procedure with both diagnostic and therapeutic utilities in managing pancreaticobiliary conditions. With the advancements of endoscopic techniques, ERCP has become a relatively safe and effective procedure. However, as ERCP is increasingly being utilized for different advanced techniques, newer complications have been noticed. Post-ERCP complications are known, and mostly include pancreatitis, infection, hemorrhage, and perforation. The risks of these complications vary depending on several factors, such as patient selection, endoscopist’s skills, and the difficulties involved during the procedure. This review discusses post-ERCP complications and management strategies with new and evolving concepts.


Endoscopic retrograde cholangiopancreatography ERCP Post-ERCP complications Post-ERCP pancreatitis 





None to report.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Talukdar R. Complications of ERCP. Best Pract Res Clin Gastroenterol. 2016;30:793–805. Scholar
  2. 2.
    Galeazzi M, Mazzola P, Valcarcel B, et al. Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians’ point of view. BMC Gastroenterol. 2018;18:38. Scholar
  3. 3.
    Ukkonen M, Siiki A, Antila A, Tyrvainen T, Sand J, Laukkarinen J. Safety and efficacy of acute endoscopic retrograde cholangiopancreatography in the elderly. Dig Dis Sci. 2016;61:3302–3308. Scholar
  4. 4.
    Siiki A, Tamminen A, Tomminen T, Kuusanmaki P. ERCP procedures in a Finnish community hospital: a retrospective analysis of 1207 cases. SJS Off Organ Finn Surg Soc Scand Surg Soc. 2012;101:45–50. Scholar
  5. 5.
    Kapral C, Muhlberger A, Wewalka F, Duller C, Knoflach P, Schreiber F. Quality assessment of endoscopic retrograde cholangiopancreatography: results of a running nationwide Austrian benchmarking project after 5 years of implementation. Eur J Gastroenterol Hepatol. 2012;24:1447–1454. Scholar
  6. 6.
    Glomsaker T, Hoff G, Kvaloy JT, Soreide K, Aabakken L, Soreide JA. Patterns and predictive factors of complications after endoscopic retrograde cholangiopancreatography. Br J Surg. 2013;100:373–380. Scholar
  7. 7.
    Rustagi T, Jamidar PA. Endoscopic retrograde cholangiopancreatography-related adverse events: general overview. Gastrointest Endosc Clin N Am. 2015;25:97–106. Scholar
  8. 8.
    Jamry A. Risk factors of pancreatitis after endoscopic sphincterotomy. Review of literature and practical remarks based on approximately 10,000 ERCPs. Polski Przeglad Chirurgiczny. 2017;89:29–33. Scholar
  9. 9.
    Chandrasekhara V, Khashab MA, Muthusamy VR, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017;85:32–47. Scholar
  10. 10.
    Elmunzer BJ. Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. Dig Endosc Off J Jpn Gastroenterol Endosc Soc. 2017;29:749–757. Scholar
  11. 11.
    Kochar B, Akshintala VS, Afghani E, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointest Endosc. 2015;81:143–149. Scholar
  12. 12.
    Keswani RN, Taft TH, Cote GA, Keefer L. Increased levels of stress and burnout are related to decreased physician experience and to interventional gastroenterology career choice: findings from a US survey of endoscopists. Am J Gastroenterol. 2011;106:1734–1740. Scholar
  13. 13.
    Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335:909–918. Scholar
  14. 14.
    Loperfido S, Angelini G, Benedetti G, et al. Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study. Gastrointest Endosc. 1998;48:1–10.CrossRefGoogle Scholar
  15. 15.
    Rabenstein T, Schneider HT, Bulling D, et al. Analysis of the risk factors associated with endoscopic sphincterotomy techniques: preliminary results of a prospective study, with emphasis on the reduced risk of acute pancreatitis with low-dose anticoagulation treatment. Endoscopy. 2000;32:10–19. Scholar
  16. 16.
    Masci E, Toti G, Mariani A, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001;96:417–423. Scholar
  17. 17.
    Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001;54:425–434.CrossRefGoogle Scholar
  18. 18.
    Vandervoort J, Soetikno RM, Tham TC, et al. Risk factors for complications after performance of ERCP. Gastrointest Endosc. 2002;56:652–656. Scholar
  19. 19.
    Christensen M, Matzen P, Schulze S, Rosenberg J. Complications of ERCP: a prospective study. Gastrointest Endosc. 2004;60:721–731.CrossRefGoogle Scholar
  20. 20.
    Cheng CL, Sherman S, Watkins JL, et al. Risk factors for post-ERCP pancreatitis: a prospective multicenter study. Am J Gastroenterol. 2006;101:139–147. Scholar
  21. 21.
    Cheon YK, Cho KB, Watkins JL, et al. Frequency and severity of post-ERCP pancreatitis correlated with extent of pancreatic ductal opacification. Gastrointest Endosc. 2007;65:385–393. Scholar
  22. 22.
    Williams EJ, Taylor S, Fairclough P, et al. Risk factors for complication following ERCP; results of a large-scale, prospective multicenter study. Endoscopy. 2007;39:793–801. Scholar
  23. 23.
    Wang P, Li ZS, Liu F, et al. Risk factors for ERCP-related complications: a prospective multicenter study. Am J Gastroenterol. 2009;104:31–40. Scholar
  24. 24.
    Cotton PB, Garrow DA, Gallagher J, Romagnuolo J. Risk factors for complications after ERCP: a multivariate analysis of 11,497 procedures over 12 years. Gastrointest Endosc. 2009;70:80–88. Scholar
  25. 25.
    Andriulli A, Loperfido S, Napolitano G, et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol. 2007;102:1781–1788. Scholar
  26. 26.
    Enochsson L, Swahn F, Arnelo U, Nilsson M, Lohr M, Persson G. Nationwide, population-based data from 11,074 ERCP procedures from the Swedish Registry for Gallstone Surgery and ERCP. Gastrointest Endosc. 2010;72:1175–1184. Scholar
  27. 27.
    Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37:383–393.CrossRefGoogle Scholar
  28. 28.
    Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–111. Scholar
  29. 29.
    Zouhairi ME, Swartz D, Shah T. Post-ERCP pancreatitis: mechanisms, risk factors, and prevention. Pancreat Disord Ther. 2013;. Scholar
  30. 30.
    Pezzilli R, Romboli E, Campana D, Corinaldesi R. Mechanisms involved in the onset of post-ERCP pancreatitis. J Pancreas. 2002;3:162–168.Google Scholar
  31. 31.
    Zitinic I, Plavsic I, Poropat G, Hauser G. ERCP induced and non-ERCP-induced acute pancreatitis: two distinct clinical entities? Med Hypotheses. 2018;113:42–44. Scholar
  32. 32.
    Yaghoobi M, Pauls Q, Durkalski V, et al. Incidence and predictors of post-ERCP pancreatitis in patients with suspected sphincter of Oddi dysfunction undergoing biliary or dual sphincterotomy: results from the EPISOD prospective multicenter randomized sham-controlled study. Endoscopy. 2015;47:884–890. Scholar
  33. 33.
    Masci E, Mariani A, Curioni S, Testoni PA. Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a meta-analysis. Endoscopy. 2003;35:830–834. Scholar
  34. 34.
    Ding X, Zhang F, Wang Y. Risk factors for post-ERCP pancreatitis: a systematic review and meta-analysis. Surgeon J R Coll Surgeon Edinb Irel. 2015;13:218–229. Scholar
  35. 35.
    Miyatani H, Matsumoto S, Mashima H. Risk factors of post-endoscopic retrograde cholangiopancreatography pancreatitis in biliary type sphincter of Oddi dysfunction in Japanese patients. J Dig Dis. 2017;18:591–597. Scholar
  36. 36.
    Phillip V, Schwab M, Haf D, Algul H. Identification of risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in a high volume center. PLoS ONE. 2017;12:e0177874. Scholar
  37. 37.
    Lin Y, Liu X, Cao DQ, et al. Analysis of risk factors and prevention strategies of post-ERCP pancreatitis. Eur Rev Med Pharmacol Sci. 2017;21:5185–5190. Scholar
  38. 38.
    Karaahmet F, Kekilli M. The presence of periampullary diverticulum increased the complications of endoscopic retrograde cholangiopancreatography. Eur J Gastroenterol Hepatol. 2018;30:1009–1012. Scholar
  39. 39.
    Mehta SN, Pavone E, Barkun JS, Bouchard S, Barkun AN. Predictors of post-ERCP complications in patients with suspected choledocholithiasis. Endoscopy. 1998;30:457–463. Scholar
  40. 40.
    Martinez J, Johnson CD, Sanchez-Paya J, de Madaria E, Robles-Diaz G, Perez-Mateo M. Obesity is a definitive risk factor of severity and mortality in acute pancreatitis: an updated meta-analysis. Off J Int Assoc Pancreatol. 2006;6:206–209. Scholar
  41. 41.
    Inamdar S, Berzin TM, Sejpal DV, et al. Pregnancy is a risk factor for pancreatitis after endoscopic retrograde cholangiopancreatography in a national cohort study. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2016;14:107–114. Scholar
  42. 42.
    Park CH, Jung JH, Hyun B, et al. Safety and efficacy of early feeding based on clinical assessment at 4 hours after ERCP: a prospective randomized controlled trial. Gastrointest Endosc. 2018;87:1040–1049. Scholar
  43. 43.
    Chen JJ, Wang XM, Liu XQ, et al. Risk factors for post-ERCP pancreatitis: a systematic review of clinical trials with a large sample size in the past 10 years. Eur J Med Res. 2014;19:26. Scholar
  44. 44.
    Maple JT, Keswani RN, Hovis RM, et al. Carbon dioxide insufflation during ERCP for reduction of postprocedure pain: a randomized, double-blind, controlled trial. Gastrointest Endosc. 2009;70:278–283. Scholar
  45. 45.
    Iida T, Kaneto H, Wagatsuma K, et al. Can trainees safely perform endoscopic treatments for common bile duct stones? A single-center retrospective study. Intern Med (Tokyo, Jpn). 2018;57:923–928. Scholar
  46. 46.
    Testoni PA, Mariani A, Giussani A, et al. Risk factors for post-ERCP pancreatitis in high- and low-volume centers and among expert and non-expert operators: a prospective multicenter study. Am J Gastroenterol. 2010;105:1753–1761. Scholar
  47. 47.
    Choudhary A, Bechtold ML, Arif M, et al. Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review. Gastrointest Endosc. 2011;73:275–282. Scholar
  48. 48.
    Mazaki T, Mado K, Masuda H, Shiono M. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol. 2014;49:343–355. Scholar
  49. 49.
    Sugimoto M, Takagi T, Suzuki R, et al. Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail. World J Gastroenterol. 2018;24:2392–2399. Scholar
  50. 50.
    Cha SW, Leung WD, Lehman GA, et al. Does leaving a main pancreatic duct stent in place reduce the incidence of precut biliary sphincterotomy-associated pancreatitis? A randomized, prospective study. Gastrointest Endosc. 2013;77:209–216. Scholar
  51. 51.
    Tse F, Yuan Y, Moayyedi P, Leontiadis GI. Guidewire-assisted cannulation of the common bile duct for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Cochrane Database Syst Rev. 2012;12:Cd009662. Scholar
  52. 52.
    Furuya CK, Sakai P, Marinho FRT, et al. Papillary fistulotomy vs conventional cannulation for endoscopic biliary access: a prospective randomized trial. World J Gastroenterol. 2018;24:1803–1811. Scholar
  53. 53.
    Pecsi D, Farkas N, Hegyi P, et al. Transpancreatic sphincterotomy has a higher cannulation success rate than needle-knife precut papillotomy—a meta-analysis. Endoscopy. 2017;49:874–887. Scholar
  54. 54.
    Fang J, Wang SL, Zhao SB, et al. Impact of intraduodenal acetic acid infusion on pancreatic duct cannulation during endoscopic retrograde cholangiopancreatography: a double-blind, randomized controlled trial. J Gastroenterol Hepatol. 2018;33:1804–1810. Scholar
  55. 55.
    Mbatshi G, Macken EJ, De Schepper HU, Piessevaux H, Deprez PH, Moreels TG. Comparison of side-viewing duodenoscope and single-balloon enteroscope to perform ERCP in patients with Billroth II gastrectomy. Acta Gastro-enterol Belg. 2017;80:493–497.Google Scholar
  56. 56.
    Elmunzer BJ, Scheiman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–1422. Scholar
  57. 57.
    Mohammad Alizadeh AH, Abbasinazari M, Hatami B, et al. Comparison of rectal indomethacin, diclofenac, and naproxen for the prevention of post endoscopic retrograde cholangiopancreatography pancreatitis. Eur J Gastroenterol Hepatol. 2017;29:349–354. Scholar
  58. 58.
    Sethi S, Sethi N, Wadhwa V, Garud S, Brown A. A meta-analysis on the role of rectal diclofenac and indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis. Pancreas. 2014;43:190–197. Scholar
  59. 59.
    Del Olmo Martinez L, Velayos Jimenez B, Almaraz Gomez A. Rectal diclofenac does not prevent post-ERCP pancreatitis in consecutive high-risk and low-risk patients. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva. 2018;110:505–509. Scholar
  60. 60.
    Lyu Y, Cheng Y, Wang B, Xu Y, Du W. What is impact of nonsteroidal anti-inflammatory drugs in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2018;18:106. Scholar
  61. 61.
    Garg R, Mohan BP, Krishnamoorthi R, Rustagi T. Pre-endoscopic retrograde cholangiopancreatography (ERCP) administration of rectal indomethacin in unselected patients to reduce post-ERCP pancreatitis: a systematic review and meta-analysis. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2018;37:120–126. Scholar
  62. 62.
    Yang C, Zhao Y, Li W, et al. Rectal nonsteroidal anti-inflammatory drugs administration is effective for the prevention of post-ERCP pancreatitis: an updated meta-analysis of randomized controlled trials. Pancreatol Off J Int Assoc Pancreatol. 2017;17:681–688. Scholar
  63. 63.
    Okuno M, Shiroko J, Taguchi D, et al. The effectiveness of the rectal administration of low-dose diclofenac for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis. Intern Med (Tokyo, Jpn). 2018;57:2289–2294. Scholar
  64. 64.
    Wang G, Xiao G, Xu L, et al. Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: a systematic review and meta-analysis. Pancreatol Off J Int Assoc Pancreatol. 2018;18:370–378. Scholar
  65. 65.
    Staritz M, Poralla T, Ewe K, Meyer Zum Buschenfelde KH. Effect of glyceryl trinitrate on the sphincter of Oddi motility and baseline pressure. Gut. 1985;26:194–197.CrossRefGoogle Scholar
  66. 66.
    Kaufman HS, Shermak MA, May CA, Pitt HA, Lillemoe KD. Nitric oxide inhibits resting sphincter of Oddi activity. Am J Surg. 1993;165:74–80.CrossRefGoogle Scholar
  67. 67.
    Luman W, Pryde A, Heading RC, Palmer KR. Topical glyceryl trinitrate relaxes the sphincter of Oddi. Gut. 1997;40:541–543.CrossRefGoogle Scholar
  68. 68.
    Carr-Locke DL, Gregg JA, Aoki TT. Effects of exogenous glucagon on pancreatic and biliary ductal and sphincteric pressures in man demonstrated by endoscopic manometry and correlation with plasma glucagon. Dig Dis Sci. 1983;28:312–320. Scholar
  69. 69.
    Katsinelos P, Lazaraki G, Chatzimavroudis G, et al. Impact of nitroglycerin and glucagon administration on selective common bile duct cannulation and prevention of post-ERCP pancreatitis. Scand J Gastroenterol. 2017;52:50–55. Scholar
  70. 70.
    Buxbaum J, Yan A, Yeh K, Lane C, Nguyen N, Laine L. Aggressive hydration with lactated Ringer’s solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2014;12:303–307. Scholar
  71. 71.
    Wu D, Wan J, Xia L, Chen J, Zhu Y, Lu N. The efficiency of aggressive hydration with lactated ringer solution for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. J Clin Gastroenterol. 2017;51:e68–e76. Scholar
  72. 72.
    Gooshe M, Abdolghaffari AH, Nikfar S, Mahdaviani P, Abdollahi M. Antioxidant therapy in acute, chronic and post-endoscopic retrograde cholangiopancreatography pancreatitis: an updated systematic review and meta-analysis. World J Gastroenterol. 2015;21:9189–9208. Scholar
  73. 73.
    Parekh PJ, Majithia R, Sikka SK, Baron TH. The “Scope” of post-ERCP pancreatitis. Mayo Clin Proc. 2017;92:434–448. Scholar
  74. 74.
    Szary NM, Al-Kawas FH. Complications of endoscopic retrograde cholangiopancreatography: how to avoid and manage them. Gastroenterol Hepatol. 2013;9:496–504.Google Scholar
  75. 75.
    Oh HC, El H II, Easler JJ, et al. Post-ERCP bleeding in the era of multiple antiplatelet agents. Gut Liver. 2018;12:214–218. Scholar
  76. 76.
    Wilcox CM, Canakis J, Monkemuller KE, Bondora AW, Geels W. Patterns of bleeding after endoscopic sphincterotomy, the subsequent risk of bleeding, and the role of epinephrine injection. Am J Gastroenterol. 2004;99:244–248.CrossRefGoogle Scholar
  77. 77.
    Hamada T, Yasunaga H, Nakai Y, et al. Bleeding after endoscopic sphincterotomy or papillary balloon dilation among users of antithrombotic agents. Endoscopy. 2015;47:997–1004. Scholar
  78. 78.
    Hussain N, Alsulaiman R, Burtin P, et al. The safety of endoscopic sphincterotomy in patients receiving antiplatelet agents: a case-control study. Aliment Pharmacol Ther. 2007;25:579–584. Scholar
  79. 79.
    Park DH, Kim MH, Lee SK, et al. Endoscopic sphincterotomy vs endoscopic papillary balloon dilation for choledocholithiasis in patients with liver cirrhosis and coagulopathy. Gastrointest Endosc. 2004;60:180–185.CrossRefGoogle Scholar
  80. 80.
    Morris ML, Tucker RD, Baron TH, Song LM. Electrosurgery in gastrointestinal endoscopy: principles to practice. Am J Gastroenterol. 2009;104:1563–1574. Scholar
  81. 81.
    Leung WK, But DY, Wong SY, et al. Prevention of post-sphincterotomy bleeding by proton pump inhibitor: a randomized controlled trial. J Dig Dis. 2018;19:369–376. Scholar
  82. 82.
    Ferreira LE, Baron TH. Post-sphincterotomy bleeding: who, what, when, and how. Am J Gastroenterol. 2007;102:2850–2858. Scholar
  83. 83.
    Canena J, Liberato M, Horta D, Romao C, Coutinho A. Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations. Surg Endosc. 2013;27:313–324. Scholar
  84. 84.
    Millward SF. ACR appropriateness criteria on treatment of acute nonvariceal gastrointestinal tract bleeding. J Am College Radiol. 2008;5:550–554. Scholar
  85. 85.
    Chen M, Wang L, Wang Y, et al. Risk factor analysis of post-ERCP cholangitis: a single-center experience. Hepatobiliary Pancreat Dis Int HBPD INT. 2018;17:55–58. Scholar
  86. 86.
    Kim NH, Kim HJ, Bang KB. Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis. Hepatobiliary Pancreat Dis Int HBPD INT. 2017;16:512–518. Scholar
  87. 87.
    Lee JM, Lee SH, Jang DK, et al. Air cholangiography in endoscopic bilateral stent-in-stent placement of metallic stents for malignant hilar biliary obstruction. Ther Adv Gastroenterol. 2016;9:189–198. Scholar
  88. 88.
    Stefanidis G, Viazis N, Pleskow D, et al. Large balloon dilation vs. mechanical lithotripsy for the management of large bile duct stones: a prospective randomized study. Am J Gastroenterol. 2011;106:278–285. Scholar
  89. 89.
    Pfau PR, Pleskow DK, Banerjee S, et al. Pancreatic and biliary stents. Gastrointest Endosc. 2013;77:319–327. Scholar
  90. 90.
    Costamagna G, Boskoski I. Current treatment of benign biliary strictures. Ann Gastroenterol. 2013;26:37–40.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Cao J, Peng C, Ding X, et al. Risk factors for post-ERCP cholecystitis: a single-center retrospective study. BMC Gastroenterol. 2018;18:128. Scholar
  92. 92.
    Irani S, Baron TH, Grimm IS, Khashab MA. EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video). Gastrointest Endosc. 2015;82:1110–1115. Scholar
  93. 93.
    Kedia P, Sharaiha RZ, Kumta NA, et al. Endoscopic gallbladder drainage compared with percutaneous drainage. Gastrointest Endosc. 2015;82:1031–1036. Scholar
  94. 94.
    Rutala WA, Weber DJ. ERCP scopes: what can we do to prevent infections? Infect Control Hosp Epidemiol. 2015;36:643–648. Scholar
  95. 95.
    Rahman MR, Perisetti A, Coman R, Bansal P, Chhabra R, Goyal H. Duodenoscope-associated infections: update on an emerging problem. Dig Dis Sci. 2018;. Scholar
  96. 96.
    Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann Intern Med. 1993;118:117–128.CrossRefGoogle Scholar
  97. 97.
    Epstein L, Hunter JC, Arwady MA, et al. New Delhi metallo-beta-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA. 2014;312:1447–1455. Scholar
  98. 98.
    Rutala WA, Weber DJ. Outbreaks of carbapenem-resistant Enterobacteriaceae infections associated with duodenoscopes: What can we do to prevent infections? Am J Infect Control.. 2016;44:e47–e51. Scholar
  99. 99.
    Kovaleva J, Peters FT, van der Mei HC, Degener JE. Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy. Clin Microbiol Rev. 2013;26:231–254. Scholar
  100. 100.
    Administration USFaD. FDA recommends health care facilities and manufacturers begin transitioning to duodenoscopes with disposable components to reduce risk of patient infection. 2019.Google Scholar
  101. 101.
    Park TY, Yang YJ, Shin SP, et al. Candidemia after endoscopic retrograde cholangiopancreatography in an immunocompetent patient: a case report and literature review. Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc. 2018;24:135–137. Scholar
  102. 102.
    Jimenez Cubedo E, Lopez Monclus J, Lucena de la Poza JL, et al. Review of duodenal perforations after endoscopic retrograde cholangiopancreatography in Hospital Puerta de Hierro from 1999 to 2014. Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva. 2018;110:515–519. Scholar
  103. 103.
    Enns R, Eloubeidi MA, Mergener K, et al. ERCP-related perforations: risk factors and management. Endoscopy. 2002;34:293–298. Scholar
  104. 104.
    Tringali A, Cintolo M, Hassan C, Adler DG, Mutignani M. Type II-III ERCP-related perforations treated with temporary fully covered self-expandable stents. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2017;49:1169–1170. Scholar
  105. 105.
    Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg. 2000;232:191–198.CrossRefGoogle Scholar
  106. 106.
    Howard TJ, Tan T, Lehman GA, et al. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery. 1999;126:658–663. (discussion 64-5).CrossRefGoogle Scholar
  107. 107.
    Lai CH, Lau WY. Management of endoscopic retrograde cholangiopancreatography-related perforation. Surgeon J R Coll Surgeon Edinb Irel. 2008;6:45–48.Google Scholar
  108. 108.
    Avgerinos DV, Llaguna OH, Lo AY, Voli J, Leitman IM. Management of endoscopic retrograde cholangiopancreatography: related duodenal perforations. Surg Endosc. 2009;23:833–838. Scholar
  109. 109.
    Morgan KA, Fontenot BB, Ruddy JM, Mickey S, Adams DB. Endoscopic retrograde cholangiopancreatography gut perforations: when to wait! When to operate! Am Surgeon. 2009;75:477–483. (discussion 83-4).PubMedGoogle Scholar
  110. 110.
    Fatima J, Baron TH, Topazian MD, et al. Pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures: diagnosis and management (Chicago, IL: 1960). Arch Surg. 2007;142:448–454. (discussion 54-5).CrossRefPubMedGoogle Scholar
  111. 111.
    Preetha M, Chung YF, Chan WH, et al. Surgical management of endoscopic retrograde cholangiopancreatography-related perforations. ANZ J Surg. 2003;73:1011–1014.CrossRefGoogle Scholar
  112. 112.
    Paspatis GA, Dumonceau JM, Barthet M, et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2014;46:693–711. Scholar
  113. 113.
    Tringali A, Pizzicannella M, Andrisani G, et al. Temporary FC-SEMS for type II ERCP-related perforations: a case series from two referral centers and review of the literature < sup/>. Scand J Gastroenterol. 2018;53:760–767. Scholar
  114. 114.
    Odemis B, Oztas E, Kuzu UB, et al. Can a fully covered self-expandable metallic stent be used temporarily for the management of duodenal retroperitoneal perforation during ERCP as a part of conservative therapy? Surg Laparosc Endosc Percutaneous Tech. 2016;26:e9–e17. Scholar
  115. 115.
    Jeon HJ, Han JH, Park S, Youn S, Chae H, Yoon S. Endoscopic sphincterotomy-related perforation in the common bile duct successfully treated by placement of a covered metal stent. Endoscopy. 2011;43:E295–E296. Scholar
  116. 116.
    Vezakis A, Fragulidis G, Nastos C, Yiallourou A, Polydorou A, Voros D. Closure of a persistent sphincterotomy-related duodenal perforation by placement of a covered self-expandable metallic biliary stent. World J Gastroenterol. 2011;17:4539–4541. Scholar
  117. 117.
    Park WY, Cho KB, Kim ES, Park KS. A case of ampullary perforation treated with a temporally covered metal stent. Clin Endosc. 2012;45:177–180. Scholar
  118. 118.
    Amodio PM, Faggiani R, Pastorelli A, et al. Selected treatments for duodenal perforation after ERCP. A report of three cases. Chir Ital. 2007;59:343–346.PubMedGoogle Scholar
  119. 119.
    Li Q, Ji J, Wang F, et al. ERCP-induced duodenal perforation successfully treated with endoscopic purse-string suture: a case report. Oncotarget. 2015;6:17847–17850. Scholar
  120. 120.
    Buffoli F, Grassia R, Iiritano E, Bianchi G, Dizioli P, Staiano T. Endoscopic, “retroperitoneal fatpexy” of a large ERCP-related jejunal perforation by using a new over-the-scope clip device in Billroth II anatomy (with video). Gastrointest Endosc. 2012;75:1115–1117. Scholar
  121. 121.
    Mutignani M, Iacopini F, Dokas S, et al. Successful endoscopic closure of a lateral duodenal perforation at ERCP with fibrin glue. Gastrointest Endosc.. 2006;63:725–727. Scholar
  122. 122.
    Li Y, Han Z, Zhang W, et al. Successful closure of lateral duodenal perforation by endoscopic band ligation after endoscopic clipping failure. Am J Gastroenterol. 2014;109:293–295. Scholar
  123. 123.
    Loske G, Rucktaschel F, Schorsch T, van Ackeren V, Stark B, Muller CT. Successful endoscopic vacuum therapy with new open-pore film drainage in a case of iatrogenic duodenal perforation during ERCP. Endoscopy. 2015;47:E577–E578. Scholar
  124. 124.
    Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010;71:446–454. Scholar
  125. 125.
    Ji Young Bang GAC. Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography. Tech Gastrointest Endosc. 2014;16:195–201. Scholar
  126. 126.
    Efthymiou M, Raftopoulos S, Antonio Chirinos J, May GR. Air embolism complicated by left hemiparesis after direct cholangioscopy with an intraductal balloon anchoring system. Gastrointest Endosc. 2012;75:221–223. Scholar
  127. 127.
    Farnik H, Weigt J, Malfertheiner P, et al. A multicenter study on the role of direct retrograde cholangioscopy in patients with inconclusive endoscopic retrograde cholangiography. Endoscopy. 2014;46:16–21. Scholar
  128. 128.
    Chavalitdhamrong D, Donepudi S, Pu L, Draganov PV. Uncommon and rarely reported adverse events of endoscopic retrograde cholangiopancreatography. Dig Endosc Off J Jpn Gastroenterol Endosc Soc. 2014;26:15–22. Scholar
  129. 129.
    Chi KD, Waxman I. Subcapsular hepatic hematoma after guide wire injury during endoscopic retrograde cholangiopancreatography: management and review. Endoscopy. 2004;36:1019–1021. Scholar
  130. 130.
    Draganov P, Cotton PB. Iodinated contrast sensitivity in ERCP. Am J Gastroenterol. 2000;95:1398–1401. Scholar
  131. 131.
    Pan JJ, Draganov PV. Adverse reactions to iodinated contrast media administered at the time of endoscopic retrograde cholangiopancreatography (ERCP). Inflamm Allergy Drug Targets. 2009;8:17–20.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineLouisiana State University Health Sciences CenterNew OrleansUSA
  2. 2.Department of Gastroenterology and HepatologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.University of Arkansas for Medical SciencesLittle RockUSA
  4. 4.VISN-16 MD Lead for Advanced Liver DiseaseCAVHSLittle RockUSA
  5. 5.Yale University School of MedicineNew HavenUSA
  6. 6.Department of Internal MedicineThe Wright Center for Graduate Medical EducationScrantonUSA

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