Information to Medical Team for patients coming to hospital following an ERCP procedure

  • Reference Number: HEY-716/2015
  • Departments: Endoscopy

Introduction

Endoscopic Retrograde Cholangio Pancreatography (ERCP) is an advanced therapeutic procedure which has a range of complications such as GI bleeding, sepsis, pancreatitis or perforation. These complications are serious and sometimes life threatening. The complications can occur a few hours after the procedure or sometimes 1 to 2 days following the procedure.

Patients presenting with one or more of the above complications should be managed as an emergency, the following management plan should be followed

  1. Urgent CT abdomen and pelvis in cases of possible perforations or in sepsis.                                        If there is evidence of perforation, discuss with surgical team on call.                                                      If there is evidence of retained stones causing biliary obstruction of biliary collection, start broad spectrum IV antibiotic and discuss with surgical/ medical team on call, there may be a need for ERCP or PTC to relieve the obstruction urgently.
  2. Broad spectrum IV antibiotics
  3. NBM and IV fluids
  4. Blood tests including amylase, CRP and clotting
  5. Senior medical/surgical review
  6. In cases of GI bleeding discuss with gastroenterology consultant on-call
  7. Consider admission to HDU/ICU for clinically unstable patient
  8. Admit to a surgical or medical admission wards; further management should be in surgical or gastroenterology ward.