P Salminen1, S Laine, R Gullichsen. 1. Department of Surgery, Turku University Central Hospital, Turku, Finland. paulina.salminen@tyks.fi
Abstract
BACKGROUND AND STUDY AIMS: The majority of recent large series on endoscopic retrograde cholangiopancreatography (ERCP) complications have been multicenter studies reflecting varying degrees of experience and ERCP volume; major ERCP complications are associated with low case volume. The aim of this study was to report and analyze the frequency of severe and fatal complications associated with ERCP at a single specialized surgical high-volume referral center (Turku University Central Hospital). METHODS: All scheduled ERCP procedures (n = 2788) at our unit between January 1997 and December 2005 were included and the procedure-related severe and fatal complications were assessed by retrospective chart review. Complications were classified as severe or fatal according to standardized guidelines. RESULTS: The number of ERCP procedures performed was 2555, of which 71% were therapeutic and 29% were diagnostic. Seventeen (0.8%) severe complications were identified in 16 patients, of whom 15 underwent a therapeutic endoscopic procedure. Of the 17 severe complications, perforation constituted five cases (0.2%), pancreatitis occurred in five patients (0.2%), bleeding in five cases (0.2%), and two patients suffered from purulent cholangitis (0.1%). Procedure-related mortality was 0.08% (n = 3). CONCLUSIONS: In our study the rate of severe or fatal complications of ERCP is low in experienced hands at a high-volume center, comparing favorably to corresponding complication rates of multicenter series, which further supports the importance of centralizing ERCP procedures in high-volume advanced centers.
BACKGROUND AND STUDY AIMS: The majority of recent large series on endoscopic retrograde cholangiopancreatography (ERCP) complications have been multicenter studies reflecting varying degrees of experience and ERCP volume; major ERCP complications are associated with low case volume. The aim of this study was to report and analyze the frequency of severe and fatal complications associated with ERCP at a single specialized surgical high-volume referral center (Turku University Central Hospital). METHODS: All scheduled ERCP procedures (n = 2788) at our unit between January 1997 and December 2005 were included and the procedure-related severe and fatal complications were assessed by retrospective chart review. Complications were classified as severe or fatal according to standardized guidelines. RESULTS: The number of ERCP procedures performed was 2555, of which 71% were therapeutic and 29% were diagnostic. Seventeen (0.8%) severe complications were identified in 16 patients, of whom 15 underwent a therapeutic endoscopic procedure. Of the 17 severe complications, perforation constituted five cases (0.2%), pancreatitis occurred in five patients (0.2%), bleeding in five cases (0.2%), and two patients suffered from purulent cholangitis (0.1%). Procedure-related mortality was 0.08% (n = 3). CONCLUSIONS: In our study the rate of severe or fatal complications of ERCP is low in experienced hands at a high-volume center, comparing favorably to corresponding complication rates of multicenter series, which further supports the importance of centralizing ERCP procedures in high-volume advanced centers.
Authors: E Masci; G Toti; A Mariani; S Curioni; A Lomazzi; M Dinelli; G Minoli; C Crosta; U Comin; A Fertitta; A Prada; G R Passoni; P A Testoni Journal: Am J Gastroenterol Date: 2001-02 Impact factor: 10.864
Authors: S Loperfido; G Angelini; G Benedetti; F Chilovi; F Costan; F De Berardinis; M De Bernardin; A Ederle; P Fina; A Fratton Journal: Gastrointest Endosc Date: 1998-07 Impact factor: 9.427
Authors: M Barthet; N Lesavre; A Desjeux; M Gasmi; P Berthezene; S Berdah; X Viviand; J C Grimaud Journal: Endoscopy Date: 2002-12 Impact factor: 10.093
Authors: Chi-Liang Cheng; Stuart Sherman; James L Watkins; Jeffrey Barnett; Martin Freeman; Joseph Geenen; Michael Ryan; Harrison Parker; James T Frakes; Evan L Fogel; William B Silverman; Kulwinder S Dua; Giuseppe Aliperti; Paul Yakshe; Michael Uzer; Whitney Jones; John Goff; Laura Lazzell-Pannell; Abdullah Rashdan; M'hamed Temkit; Glen A Lehman Journal: Am J Gastroenterol Date: 2006-01 Impact factor: 10.864
Authors: T Rabenstein; H T Schneider; D Bulling; M Nicklas; A Katalinic; E G Hahn; P Martus; C Ell Journal: Endoscopy Date: 2000-01 Impact factor: 10.093
Authors: Mark E Benson; Siobhan Byrne; Donald J Brust; Bradley Manning; Patrick R Pfau; Terrence J Frick; Mark Reichelderfer; Deepak V Gopal Journal: Dig Dis Sci Date: 2010-02-26 Impact factor: 3.199
Authors: Jan Siert K Reinders; Dirk J Gouma; Dirk T Ubbink; Bert van Ramshorst; Djamila Boerma Journal: World J Surg Date: 2014-09 Impact factor: 3.352
Authors: Michael F Nentwich; M Reeh; F G Uzunoglu; K Bachmann; M Bockhorn; J R Izbicki; Y K Vashist Journal: World J Surg Date: 2016-09 Impact factor: 3.352