152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...

Congress Short Report Falk Symposium 152
H.-J. Schulz J. Špičák
The risks are higher with ERCP
The risk of complications is significantly higher
with ERCP than with polypectomy, said
H.-J. Schulz (Berlin), noting that the most
common and the most serious complication
is pancreatitis. Pancreatitis takes a severe course
in 10–15% of cases and pancreatitis is the most
common cause of death following ERCP. Risk
factors include female gender, sphincter of
Oddi dysfunction and pre-existing pancreatitis
(figure 16). Further complications include bleeding,
cholangitis and perforation. Added to this
are the complications secondary to sedation.
The risk of complications is different for diagnostic
and therapeutic ERCP; the rate of complications
is necessarily higher with the latter. Complications
for the most part relate to the sphincterotomy
and in general depend on the extent
of the procedure. Hence, one should avoid diagnostic
ERCP in cases in which less invasive procedures
can provide the required data.
Perforation is the main risk in
patients undergoing dilatation
Unlike polypectomy and ERCP, the most common
complication of endoscopic dilatation is
perforation. In general, however, endoscopic
dilatation, said J. Špičák (Prague), is considered
an established procedure that can be safely used
in practically all forms of strictures and stenoses
of the gastrointestinal tract (figure 17), whether
due to benign or malignant processes.
Highly amenable to endoscopic treatment are
stenoses associated with benign disorders of the
esophagus and colon. Methods include balloon
dilatation, use of sounds, electrocoagulation and
the placement of temporary stents, or even a
combination of these different techniques,
J. Špičák said.
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