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

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.

Bir acil cerrahi kliniðinin endoskopik retrograd kolanjiyopankreatografi komplikasyonlarý ile ilgili deneyimi

AMAÇ: Bu çalýþmanýn amacý farklý endoskopi merkezleri tarafýndan kliniðimize yönlendirilen endoskopik retrograd kolanjiyopankreatografi (ERCP) komplikasyonlarý ile ilgili deneyimimizi aktarmaktýr.
GEREÇ VE YÖNTEM: ERCP komplikasyonu nedeniyle Ekim 2005–Ocak 2014 tarihleri arasýnda acil cerrahi kliniðimize yönlendirilen 54 hastanýn kayýtlarý geriye dönük incelendi.
BULGULAR: Çalýþmada 25 kadýn, 29 erkek hasta yer aldý. Pankreatit en sýk görülen komplikasyon (%38.8) idi. Perforasyon (%27.7), enfeksiyon
(%20.3) ve kanama (%12.9) diðer sýk görülen komplikasyonlardý. En yüksek oran perforasyonlu hastalarda (%40) olmak üzere olgularýn %22.2’si ölüm ile sonuçlandý. Ölen olgularýn ortalama yaþý 75.9 idi (daðýlým, 47–94). Ölümlerin %41.6’sý ERCP sonrasý ilk hafta, %33.3’ü ikinci hafta içerisinde gerçekleþti. Ölen hastalarýn %50’sinde malign bir hastalýk mevcuttu (birisinde metastatik meme kanseri, birisinde safra kesesi tümörü, birisinde duedonum tümörü, üçünde periampuller tümör). Ölen hastalarýn %50’sinde kardiyopulmoner ve/veya serebrovasküler hastalýklar da mevcuttu.
TARTIÞMA: Risk faktörlerini bilerek uygun yönetimin saðlanmasý komplikasyon oranýný en aza indirse de tamamen ortadan kaldýramaz. Orta ve ciddi dereceli komplikasyonlar özellikle yüksek riskli hastalarda mortaliteyi artýrabilir.