What Are the Potential Complications of ERCP?

T. Broderick

There are four potential complications of ERCP. Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure done to diagnose and treat disorders of the bile or pancreatic ducts. The complications that can arise during or immediately after surgery are: pancreatitis, gut perforation, over-sedation and an allergic reaction to the dye used during the procedure. The complications of ERCP are rarely serious or life-threatening.

ERCP procedures carry the risk of perforating the small intestine.
ERCP procedures carry the risk of perforating the small intestine.

ERCP is both a diagnostic tool and treatment delivery system. Using endoscopy, a camera attached to a long, thin tube is sent through the mouth and into the small intestine. After the endoscope injects special dye into the bile ducts, surgeons can locate clogged ducts, tumors, gallstones and strictures, or narrow areas, through the use of x-rays. If a surgeon detects one of these problems, he or she can remove gallstones, insert a stent or dilate a stricture all during the same procedure. Though complications of ERCP are uncommon, patients should still be aware of what can go wrong.

Endoscopy is used to examine the small intestine.
Endoscopy is used to examine the small intestine.

Pancreatitis, an inflammation of the pancreas, occurs in roughly five percent of patients who undergo ERCP. It occurs when the endoscope transfers food-digesting enzymes from the small intestine to the pancreas. The condition can be very painful. As the patient who experiences it due to ERCP is already hospitalized, physicians can administer pain medication and IV fluids until the condition clears up after one to two days.

Gut perforation is a risk of all endoscopic surgeries. Breaking tissue during the procedure can lead to internal bleeding. When gut perforation occurs during ERCP, surgeons generally notice it when dye leaks from the pancreatic or bile ducts. If the cut is small enough, endoscopic surgery is possible.

Over-sedation is another one of the complications of ERCP. Due to the endoscope having to go through the stomach to reach the ducts, over-sedation can result in post-surgical nausea and vomiting. Vomiting can be extremely painful, as most patients experience some stomach pain the day after the procedure. Low blood pressure is another risk of over-sedation. In most cases, physicians will require patients who vomit or have low blood pressure to remain in the hospital for an extra day or two.

Out of all the complications of ERCP, an allergic reaction to the contrast dye used during the procedure is the rarest. This is due to the fact that pre-surgical screening and examination reveal the patient's allergies. Though the allergy is usually mild, surgeons can administer anti-allergy medication if they notice the patient is having an allergic reaction during surgery.

Over-sedation during ERCP may cause nausea and vomiting.
Over-sedation during ERCP may cause nausea and vomiting.

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