Institutional experience in the surgical management of major ERCP-related complications

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is a common therapeutic procedure for biliary and pancreatic diseases. However, severe complications such as duodenal perforation and nec-rotizing pancreatitis may require urgent surgical intervention. This study aimed to present our institution-al approach to the management of ERCP-related complications, including both surgical and conservative strategies.
METHODS: In our clinic, seventeen patients who were hospitalized and followed due to ER-CP-related complications between January 2022 and December 2024 were evaluated retrospectively. Data on patient demographics, type of complication, management approach, hospital stay, and outcomes were analyzed descriptively.
RESULTS: Seven patients underwent surgical intervention due to major complications such as duodenal per-foration and necrotizing pancreatitis, while ten patients were managed conservatively due to pancreatitis, cholangitis, or bleeding. Early surgical intervention in appropriately selected patients was effective in con-trolling contamination and preventing sepsis. Conservatively managed patients responded well to support-ive care, with no mortality. One patient who had undergone surgery died due to complications.
DISCUSSION AND CONCLUSION: Management of ERCP-related complications should be individualized based on the type and severity of the complication. Early surgery is lifesaving in selected cases, while conservative treatment is sufficient for stable patients. A multidisciplinary approach is essential for optimizing outcomes.

Keywords: ERCP, duodenal perforation, necrotizing pancreatitis, surgical approach