Managing endoscopic retrograde cholangiopancreatography-related complications in patients referred to the surgical emergency unit [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 2017; 23(5): 395-399 | DOI: 10.5505/tjtes.2017.05435  

Managing endoscopic retrograde cholangiopancreatography-related complications in patients referred to the surgical emergency unit

Osman Şimsek, Arife Şimsek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci
Department of General Surgery, İstanbul University, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey

BACKGROUND: The goal of this study was to present our experience in the management of endoscopic retrograde cholangiopan- creatography-related complications in patients referred to our surgical emergency unit by various endoscopy centers.
METHODS: A retrospective investigation was conducted on the records of the 54 patients who were referred to our surgical emer- gency unit between October 2005 and January 2014 due to endoscopic retrograde cholangiopancreatography-related complications.
RESULTS: There were 25 and 29 female and male patients, respectively. Pancreatitis was the most common complication (38.8%). Perforation (27.7%), infection (20.3%), and bleeding (12.9%) were the other complications. In 22.2% of cases, patients were died. The mortality rate was the highest in patients with perforation (40%). The mean age of the patients who were died due to complications was 75.9 years (range, 47–94 years). In total, 41.6% of the patients were died within the first week and 33.3% were died within the second week following ERCP. Nearly half of these patients had a cancerous disease (one had metastatic breast cancer, one had a gallbladder cancer, one had a duodenal cancer, and the other three had periampullary cancers) and 50% of the patients who died also had cardiopulmonary and/or cerebrovascular disorders.
CONCLUSION: Comprehending and managing the main risk factors can minimize complications; however, they would not be elimi- nated. Moderate and severe complications may increase the mortality rates, particularly in high-risk patients.

Keywords: Complication, endoscopy, ERCP, infection, pancreatitis, perforation.


Bir acil cerrahi kliniğinin endoskopik retrograd kolanjiyopankreatografi komplikasyonları ile ilgili deneyimi

Osman Şimsek, Arife Şimsek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci
İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul

AMAÇ: Bu çalışmanın amacı farklı endoskopi merkezleri tarafından kliniğimize yönlendirilen endoskopik retrograd kolanjiyopankreatografi (ERCP) komplikasyonları ile ilgili deneyimimizi aktarmaktır.
GEREÇ VE YÖNTEM: ERCP komplikasyonu nedeniyle Ekim 2005–Ocak 2014 tarihleri arasında acil cerrahi kliniğimize yönlendirilen 54 hastanın kayıtları geriye dönük incelendi.
BULGULAR: Çalışmada 25 kadın, 29 erkek hasta yer aldı. Pankreatit en sık görülen komplikasyon (%38.8) idi. Perforasyon (%27.7), enfeksiyon
(%20.3) ve kanama (%12.9) diğer sık görülen komplikasyonlardı. En yüksek oran perforasyonlu hastalarda (%40) olmak üzere olguların %22.2’si ölüm ile sonuçlandı. Ölen olguların ortalama yaşı 75.9 idi (dağılım, 47–94). Ölümlerin %41.6’sı ERCP sonrası ilk hafta, %33.3’ü ikinci hafta içerisinde gerçekleşti. Ölen hastaların %50’sinde malign bir hastalık mevcuttu (birisinde metastatik meme kanseri, birisinde safra kesesi tümörü, birisinde duedonum tümörü, üçünde periampuller tümör). Ölen hastaların %50’sinde kardiyopulmoner ve/veya serebrovasküler hastalıklar da mevcuttu.
TARTIŞMA: Risk faktörlerini bilerek uygun yönetimin sağlanması komplikasyon oranını en aza indirse de tamamen ortadan kaldıramaz. Orta ve ciddi dereceli komplikasyonlar özellikle yüksek riskli hastalarda mortaliteyi artırabilir.

Anahtar Kelimeler: Endoskopi, enfeksiyon, ERCP, komplikasyon, pankreatit, perforasyon.


Osman Şimsek, Arife Şimsek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci. Managing endoscopic retrograde cholangiopancreatography-related complications in patients referred to the surgical emergency unit. Ulus Travma Acil Cerrahi Derg. 2017; 23(5): 395-399

Corresponding Author: Arife Şimsek, Türkiye


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