Korean J Pancreas Biliary Tract.  2017 Jan;22(1):24-34. 10.15279/kpba.2017.22.1.24.

Post-Endoscopic Retrograde Cholangiopancreatography Infection

Affiliations
  • 1Department of Gastroenterology, Bundang Jesaeng General Hospital, Seongnam, Korea. parkjs@dmc.or.kr

Abstract

Infection is a known complication of endoscopic retrograde cholangiopancreatography (ERCP), occurring in up to 1.5% of cases. However, it is important to realize that true incidence may be underestimated because infection may go unnoticed. Post-ERCP infections are considered to be endogenous infections arising from the intestinal bacteria of the patient and introduction of exogenous bacteria through inadequately reprocessed duodenoscopes. During the past years, carbapenem resistance has become a major concern for public health. The infection outbreaks after ERCP are linked to breaches in adherence to disinfection manual and complex design of duodenoscopes difficult to reprocess. The most important risk factor for ERCP-related cholangitis is inadequate biliary drainage. To minimize the risk of post-ERCP infection it would be helpful that the volume of contrast injected into the biliary tree has to be minimized to obtain adequate cholangiogram. In patients with bile duct obstruction and failed drainage of infected bile via ERCP, every effort should be made to achieve prompt decompression of an obstructed biliary system. Antibiotic prophylaxis is recommended only in patients with biliary obstruction in which there is a possibility that complete drainage may not be achieved at the ERCP.

Keyword

Endoscopic retrograde cholangiopancreatography; Cholangitis; Cholecystitis; Disinfection; Antibiotic prophylaxis

MeSH Terms

Antibiotic Prophylaxis
Bacteria
Bile
Biliary Tract
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Cholecystitis
Cholestasis
Decompression
Disease Outbreaks
Disinfection
Drainage
Drug Resistance, Bacterial
Duodenoscopes
Humans
Incidence
Public Health
Risk Factors
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