DEPENDENCE OF COMPLICATIONS AFTER ERCP ON THE NATURE OF EXTRAHEPATIC BILE TRACT OBSTRUCTION

Abstract

Summary. Background. Endoscopic retrograde cholangiopancreatography (ERCP) and associated interventions play a crucial role in the diagnosis and treatment of choledocholithiasis, correction of malignant biliary obstruction, and pathology of the major duodenal papilla. The main complications of ERCP are acute pancreatitis, bleeding, perforation, cholangitis and acute cholecystitis. Aim. To analyze the presence of complications following ERCP and endoscopic interventions, depending on the nature of the obstruction of the extrahepatic biliary tract – malignant or non-malignant. Materials and Methods. We analyzed 604 cases of extrahepatic bile duct obstruction (EHBDO) in which endoscopic techniques were utilized for treatment. Results. Among 498 patients with non-malignant obstruction, acute pancreatitis occurred in 35 (7%), bleeding in 14 (2.8%), perforation in 1 (0.2%), cholangitis in 1 (0.2%), and acute cholecystitis in 4 (0.8%). Among 106 patients with tumor obstruction, the respective figures were 2 (1.9%), 3 (2.8%), 1 (1%), and no cases of acute cholecystitis. Conclusions. The most common complication following ERCP and endoscopic interventions on the biliary tract is acute pancreatitis (6.1%). It occurs significantly more frequently in cases of non-malignant EHBDO (p=0.046). Bleeding, perforation, and acute cholecystitis were observed in 2.8%, 0.3%, and 0.7% of patients, respectively. No statistical differences were found between malignant and non-malignant obstructions in terms of these complications (p>0.05). Cholangitis, occurring in 0.7% of cases, was significantly more common in patients with tumor-related EHBDO (p=0.003) and was associated with the failure of endoscopic bliary decompression.