Oro-pharyngeal Symptoms after Endoscopic Retrograde Cholangiopancreatography. How Concerned Should We Be?

In t roduc t i on : Endoscopic re t rograde cholangiopancreatography (ERCP) has always been recognized as the digestive endoscopy procedure most frequently associated with adverse events and complications. Acute pancreatitis, bleeding, perforations and infections are the usual cited procedural adverse events. The aim of our study was to evaluate whether ERCP is prone to post-procedural oro-pharyngeal symptoms compared to usual gastroscopy. Materials and methods: The prospective study enrolled 155 patients of whom 90 underwent ERCP for choledocholithiasis and 65 were examined by conventional front view gastroscopy in a tertiary unit of gastroenterology and hepatology, between January and July 2017. The presence of immediate postprocedural and of 48 hour oro-pharyngeal pain and/or discomfort was assessed. Results and discussion: No significant differences were recorded as to the presence of oro-pharyngeal symptoms in the two groups. Nevertheless, over 38% of the patients did experience such symptoms immediately after endoscopy, while in up to more than 14% of them the symptoms did not disappear in the first 48 hours. Conclusions: Oro-pharyngeal symptoms, a reality of the digestive endoscopy procedures, should be considered as precocious adverse events associated with upper digestive tract endoscopy. Even if complete resolution of symptoms is expected to occur in most patients after 24 hours, there are cases when prolonged discomfort could happen.