Experience on endoscopic retrograde cholangiopancreatography at tertiary referral center in Thailand: Risks and complications

Background: Several complications from ERCP have been described, including pancreatitis, hemorrhage, perforation, and cholangitis. The actual incidences and risk factors in Thailand have never been analyzed. Material and Method: The authors retrospectively reviewed the outcome of ERCP at Chulalongkorn University Hospital between September 2000 and December 2002. Potential risk factors were statistically assessed. Results: The incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 3.6%, 2.1%, 1.2% and 6%, respectively. Risk factors of pancreatitis were the suspected diagnosis of sphincter of Oddi dysfunction and pancreatic interventions, especially through minor papilla. Prophylactic pancreatic duct stent prior to precut sphincterotomy may reduce the incidence of pancreatitis. Hemorrhage was associated with duodenal diverticulum. The incidence of cholangitis was higher in biliary duct dilation and cholangiocarcinoma, especially hilar involvement. Conclusion: Incidence of these complications was comparable to international series with similar risk factors. Cholangitis developed more frequently probably due to a higher incidence of cholangiocarcinoma.