Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic modality to a primarily therapeutic procedure for pancreatic and biliary disorders. ERCP alone or with associated biliary and pancreatic instrumentation and therapy can cause a variety of short-term adverse events, including pancreatitis, hemorrhage, perforation, and cardiopulmonary events. These adverse events can range from minor—with one or two additional hospital days followed by full recovery—to severe and devastating—with permanent disability or death. Adverse events may cause not only significant morbidity to the patient but also significant anxiety and exposure to medical malpractice claims for the endoscopist. Major advances in the approach to adverse events of ERCP have occurred in several areas: standardized consensus-based definitions of adverse events, large-scale multicenter multivariate analyses that have allowed clearer identification of patient-related and technique-related risk factors for adverse events, and introduction of new devices and techniques to minimize the risks of ERCP-related adverse events. © 2019 Elsevier Inc. All rights reserved.