Death after ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) can be a safe and effective procedure. However, the procedure can cause or complicate a number of health conditions. Death after ERCP has occurred in cases of severe post-procedure complications.

ERCP Death Statistics

According to data collected by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), roughly 37 percent of death after ERCP occurs during the first week of ERCP recovery. Roughly 30 percent of death after ERCP occurs in the second week after the procedure is performed. This research indicates that post-ERCP monitoring is critical in the days following a procedure.

Death after Therapeutic ERCP

Research indicates that rates of death after ERCP are twice as likely to occur after therapeutic ERCP as after diagnostic ERCP. An ERCP procedure can be used for diagnostic or therapeutic purposes. During diagnostic ERCP, the patient’s medical condition is identified, but not treated. During therapeutic ERCP, the patient’s condition is treated. Therapeutic ERCP typically includes removal of gallstones and other obstructions that cause blockages in the pancreatic and bile ducts.

Causes of Death after ERCP

Death after ERCP may result due to complications such as:

  • Acute pancreatitis, or sudden onset inflammation of the pancreas
  • Pre-existing chronic pancreatitis
  • Pre-existing cancer
  • Infection such as cholangitis and cholecystitis
  • Sepsis, or bodily inflammation as a result of infection
  • Perforation of the gastrointestinal or biliary organs
  • Hemorrhage, or major bleeding
  • Cardiopulmonary complications

Cardiopulmonary Death after ERCP

Cardiopulmonary complications after ERCP are a leading cause of death after ERCP. However, these complications are rare. Cardiopulmonary complications are complications that involve the cardiac or pulmonary systems, or the heart and lungs. These complications may develop due to underlying disease or issues with sedatives and analgesics used during the procedure.

Cardiopulmonary death after ERCP may be caused by:

  • Cardiac arrhythmia, or irregular heartbeat
  • Hypoventilation, or breathing that is too slow or shallow
  • Aspiration, or the entry of material into the respiratory tract

Preventing Death after ERCP

Before the ERCP Procedure

In some cases, death after ERCP can be prevented by thorough examination before and after the procedure. Patients should be qualified candidates for ERCP. Pre-existing health conditions which may lead to complications should be diagnosed by the medical professionals performing the ERCP procedure.

After ERCP Procedure

In some cases, death after ERCP can also be prevented by patient monitoring and education. NCEPOD notes that death after ERCP most commonly occurs within four days of the ERCP procedure. Typically, ERCP patients are discharged from the medical facility before this period. Since patients are not in the direct supervision of medical professionals, they should be aware of symptoms that indicate complications which may lead to death after ERCP.

Patients should be aware of warning signs such as:

  • Fever or chills
  • Nausea or vomiting
  • Reduced appetite
  • Abnormal abdominal pain
  • Jaundice, or yellowing of the eyes and skin


“Complications and Death.” National Confidential Enquiry into Patient Outcome and Death. National Confidential Enquiry into Patient Outcome and Death. Web. 11 Jul 2013. <>.

Kuipers, EJ, et al. “Predictors if Complications after Endoscopic Retrograde Cholangiopancreatography: A Prognostic Model for Early Discharge.” Surgical Endoscopy. 25.9 (2011): 2892-2900. MEDLINE with Full Text. Web. 11 July 2013.

Salminen, Paulina, et al. “Severe and fatal complications after ERCP: Analysis of 2555 procedures in a single experienced center.” Surgical Endoscopy. 22.9 (2008): 1965-1970. Print.

Stromberg, Cecelia, et al. “Possible mortality reduction by endoscopic sphincterotomy during endoscopic retrograde cholangiopancreatography: a population-based case–control study.” Surgical Endoscopy. 26.5 (2012): 1369-1376. Print.