Endoscopic retrograde cholangiopancreatography-related adverse events: What is the role of surgery today?

Figure 1 Algorithmic approach to post-sphincterotomy bleeding, outlining the management strategies for complete sphincterotomy-related bleeding and massive bleeding. Treatment options include balloon tamponade, epinephrine injection, mechanical therapies (through-the-scope clip, metal stent), thermal therapy, angiography, embolisation, and surgical ligation when necessary. TTSC: Through-the-scope clip.

Figure 2 Algorithmic approach to the management of endoscopic retrograde cholangiopancreatography-related perforations, outlining diagnostic and therapeutic strategies. Treatment options include endoscopic interventions (through the scope and over the scope clipping), conservative management (nasogastric/nasojejunal tube placement, antibiotics, and fasting), and advanced techniques such as endoscopic ultrasound-guided drainage or surgical intervention for severe cases. ERCP: Endoscopic retrograde cholangiopancreatography; TTS: Through the scope; OTS: Over the scope; NG: Nasogastric; NJ: Nasojejunal; EUS: Endoscopic ultrasound.