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Okano et al. Mini-invasive Surg 2021;5:29 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.15

Review Open Access

Prevention and management of ERCP-related

complications

Naoki Okano, Ken Ito, Kensuke Takuma, Seiichi Hara, Yoshinori Igarashi
Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of
Medicine, Toho University, Tokyo143-8541, Japan.

Correspondence to: Prof. Naoki Okano, Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori),
School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omorinishi, Ohta-ku, Tokyo, 143-8541, Japan.
E-mail: n-okano@med.toho-u.ac.jp
How to cite this article: Okano N, Ito K, Takuma K, Hara S, Igarashi Y. Prevention and management of ERCP-related
complications. Mini-invasive Surg 2021;5:29. https://dx.doi.org/10.20517/2574-1225.2021.15
Received: 7 Feb 2021 First Decision: 17 Mar 2021 Revised: 12 Apr 2021 Accepted: 26 Apr 2021 Published: 11 Jun 2021

Academic Editor: Jean-François Rey Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) and its related procedures are established as necessary
and indispensable techniques in the diagnosis and treatment of bilio-pancreatic diseases. However, these
procedures are associated with a high risk of complications, and caution is needed as the complications may
occasionally follow a fatal course. The primary complications are pancreatitis, bleeding, perforation, and issues
associated with biliary stents and lithiasis treatment. Endoscopists must perform ERCP with a strong understanding
of the mechanisms of each of these complications and should be familiar with the prevention and
countermeasures.

Keywords: ERCP, complications, prevention of complications, countermeasure of complications

INTRODUCTION
The complication rate of endoscopic retrograde cholangiopancreatography (ERCP)-related procedures is
high among other endoscopic techniques, and complications may deteriorate into more serious conditions
occasionally. Accordingly, it is necessary to be familiar with methods to prevent complications and to treat
them should these occur. Here, we describe the primary complications associated with endoscopic therapies
for biliary disease and discuss possible treatment approaches.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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