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Adverse events and their management during peroral cholangioscopy and pancreatoscopy Hironari Kato 1 , Takeshi Tomoda 1 , Akihiro Matsumi 2 , Kazuyuki Matsumoto 2 1Gastrointestinal Medicine,Okayama City Hospital, Okayama, Japan 2Gastrointestinal Medicine, Okayama University Hospital, Okayama, Japan Keyword: peroral cholangioscopy , peroral pancreatoscopy , adverse event pp.904-910
Published Date 2025/7/25
DOI https://doi.org/10.24479/endo.0000002138
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 Adverse events (AE) associated with peroral cholangioscopy and pancreatoscopy include those with routine ERCP-related procedures such as sphincterotomy prior to scope insertion, and those with insertion of the cholangoscope and pancreatoscope and subsequent procedures. It is difficult to completely distinguish between these AE. The overall frequency of AE with peroral cholangioscopy is 0-25.4%. Details of AE incidents and their frequencies are: cholangitis accounting for 0-13.8%, pancreatitis for 0-11.2%, hemorrhage for 0-15.4%, and perforation for 0-10.3%. The overall frequency of AE associated with peroral pancreatoscopy for IPMN is 12% (95%CI: 9-17%). Pancreatitis, which is the most common AE, occurred in 10% (95%CI: 7-15%) patients. The overall frequency of AE associated with pancreatic stone lithotripsy is 14.9% (95%CI: 9.2-23.2%), including pancreatitis in 7% of cases (95%CI: 5.5-13.6%) and perforation in 4.3% (95%CI: 9.2-23.2%). In both cholangioscopy and pancolangioscopy, it is important to pay attention to edema of the duodenal papilla due to aggressive scope insertion, increased internal pressure due to water infusion, and injury of the mucosa during lithotripsy. In addition, appropriate drainage for intraluminal decompression before and after the procedure is important in order to avoid any occurrence of AE.


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電子版ISSN 印刷版ISSN 0915-3217 東京医学社

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