The most frequent complications of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic biliary sphincterotomy are pancreatitis, cholangitis, hemorrhage, and duodenal perforation. A number of less common adverse events have also been described including cardiopulmonary complications, contrast allergy, impaction of a retrieval basket and numerous other events reported in only small numbers of patients or individual case reports. These unusual adverse events, which may be difficult to manage, can be associated with significant morbidity and mortality [1,2].
This topic review will focus on uncommon and rare complications of ERCP. Complications that occur more frequently are discussed separately.
Uncommon complications of ERCP have been described in several large studies.
●Miscellaneous complications occurred in 25 of 2347 cases (1 percent) in a prospective series of patients who underwent biliary sphincterotomy . Six of these were cardiopulmonary events, which were fatal in three patients.
●Similar findings were noted in two Italian prospective series that included a total of 4872 patients undergoing diagnostic and therapeutic ERCP [4,5]. Miscellaneous complications were observed in 0.4 to 0.5 percent of patients, more than one-half of which were cardiopulmonary.