Simsar M, Yuruk YY, Sahin O, Sahin H. Complications and expected imaging findings after endoscopic retrograde cholangiopancreatography. World J Radiol 2025; 17(9): 110214 [PMID: 41025062 DOI: 10.4329/wjr.v17.i9.110214]
Corresponding Author of This Article
Hilal Sahin, MD, Associate Professor, Department of Radiology, University of Health Sciences, Izmir City Hospital, Şevket ince mahallesi, 2148/11. Bayraklı, Izmir 35540, Türkiye. hilalcimen@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Sep 28, 2025; 17(9): 110214 Published online Sep 28, 2025. doi: 10.4329/wjr.v17.i9.110214
Complications and expected imaging findings after endoscopic retrograde cholangiopancreatography
Mehmet Simsar, Yesim Yekta Yuruk, Olgun Sahin, Hilal Sahin
Mehmet Simsar, Olgun Sahin, Hilal Sahin, Department of Radiology, University of Health Sciences, Izmir City Hospital, Izmir 35540, Türkiye
Yesim Yekta Yuruk, Department of Radiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir 35020, Türkiye
Author contributions: Simsar M and Sahin H conceptualized and designed the study; Simsar M, Yuruk YY, and Sahin O conducted the literature review, carried out the analysis, drafted the original manuscript, and made critical revisions; Sahin H supervised the review, advised the review design, and critically revised the manuscript; All authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hilal Sahin, MD, Associate Professor, Department of Radiology, University of Health Sciences, Izmir City Hospital, Şevket ince mahallesi, 2148/11. Bayraklı, Izmir 35540, Türkiye. hilalcimen@gmail.com
Received: June 3, 2025 Revised: July 15, 2025 Accepted: September 5, 2025 Published online: September 28, 2025 Processing time: 117 Days and 20.1 Hours
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a cornerstone procedure for the diagnosis and management of pancreatic and hepatobiliary diseases. Although its diagnostic role has been increasingly supplanted by noninvasive imaging modalities such as magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography, the therapeutic applications of ERCP have continued to expand. ERCP is widely used and has a generally favorable safety profile. However, it is important to recognize expected post-procedural imaging findings and serious complications that can arise. The increasing complexity of therapeutic interventions and the growing volume of procedures have led to a higher incidence of complications that often present with overlapping clinical and laboratory features, underscoring the critical role of imaging in differential diagnosis. This review focused on the typical normal ERCP findings and the imaging characteristics of common complications, including pancreatitis, bleeding, ERCP-related infections, perforations, and stent-related complications. Computed tomography (CT) is particularly valuable in timely recognition, management, and surgical decision-making for these complications. Furthermore, MRI offers a radiation-free alternative for managing complications in selected patients. Therefore, radiological modalities, particularly CT and MRI, are critical tools for the rapid diagnosis, management, and surgical decision-making processes for post-ERCP complications.
Core Tip: Endoscopic retrograde cholangiopancreatography (ERCP) is a standard procedure for treating pancreaticobiliary diseases that was driven by technological advances and improved procedural feasibility. However, the widespread use of ERCP is accompanied by a range of potential complications. Imaging modalities are frequently relied upon to identify, classify, monitor, and manage ERCP-related complications. Differentiating normal post-procedural changes from pathological findings is essential. This review provided a comprehensive overview of the normal post-ERCP imaging appearances and the spectrum of potential complications.
