[Complications after endoscopic interventions on the major duodenal papilla].

An analysis of 83 cases of complications following endoscopic procedures on the major duodenal papilla was made: 62 cases after 2110 retrograde cholangiopancreatographies (RChPG) and 21 after 620 endoscopic papillosphincterotomies (EPST). Among most frequent complications there were acute pancreatitis (49 cases), purulent cholangitis (11 cases), suppurations of the pancreatic cysts and purulent pancreatitis (8 cases). Bleedings took place after EPST in 11 patients. Risk factors of the development of acute pancreatitis were established: the presence of scarry stenosis of the papilla, chronic pancreatitis with the last exacerbation less than 1 month before the examination, more than 3 cannulations and contrasts of the pancreatic duct of the 2nd order or its acini, little (less than 10 mm) cuts of the papilla in EPST. Acute obturative pancreatitis is not a contraindication for EPST. On the opposite, after the procedure a rapid regression of the disease takes place. Asymptomatic hyperamylasuria observed in 329 patients (238 patients after RChPG and 91 after EPST) is considered to be a manifestation of flaccid pancreatitis, suggests a complication of the endoscopic procedure and is considered to be an indication for the corresponding treatment. Operations for the complications were performed on 21 patients. Four patients died because of complications of RChPG (0.2%) and two from complications of EPST (0.5%). Pancreonecrosis and purulent pancreatitis were causes of the deaths.