Patient Management before and after EUS/ERCP

  • Katja S. RothfussEmail author
  • Jörg G. Albert


Good patient management already starts in advance with careful evaluation of the patient's history and condition with all comorbidities and strict indication of the endoscopic procedure, either for endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP). This is necessary to avoid complications of these potentially risky endoscopic interventions. Another important requirement before endoscopy is informed written consent of the patient. During the endoscopic procedure, excellent patient management includes cautious sedation, simultaneous monitoring, radiation protection, an experienced endoscopy team considering prophylaxis and management of potential complications. Only by considering all these aspects a successful procedure and full patient satisfaction will be achieved.


Risk factors Informed consent Endoscopic ultrasonography (EUS) Endoscopic retrograde cholangiopancreatography (ERCP) Sedation Radiation protection Antibiotic prophylaxis Monitoring Complications Team Time-out 


  1. 1.
    Finkelmeier F, Tal A, Ajouaou M, Filmann N, Zeuzem S, Waidmann O, Albert JG. ERCP in old and very old patients—increased risk of sedation complications but low frequency of post-ERCP pancreatitis. Gastrointest Endosc. 2015. pii: S0016-5107(15)02392-5.
  2. 2.
    Manes G, et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2019;51:472–91.
  3. 3.
    Denzer U, et al. S2k-Leitlinie Qualitätsanforderungen in der gastrointestinalen Endoskopie. Z Gastroenterol. 2015;53:1496–530. Scholar
  4. 4.
    Dumonceau JM, Riphaus A, Schreiber F, Vilmann P, Beilenhoff U, Aparicio JR, Vargo JJ, Manolaraki M, Wientjes C, Rácz I, Hassan C, Paspatis G. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline—updated June 2015. Endoscopy. 2015;47(12):1175–89. Epub 2015 Nov 12.CrossRefGoogle Scholar
  5. 5.
    Dumonceau JM, Garcia-Fernandez FJ, Verdun FR, Carinou E, Donadille L, Damilakis J, Mouzas I, Paraskeva K, Ruiz-Lopez N, Struelens L, Tsapaki V, Vanhavere F, Valatas V, Sans-Merce M, European Society of Digestive Endoscopy. Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy. 2012;44(4):408–21. Epub 2012 Mar 21.CrossRefPubMedGoogle Scholar
  6. 6.
    Draganov PV, Forsmark CE. Prospective evaluation of adverse reactions to iodine-containing contrast media after ERCP. Gastrointest Endosc. 2008;68(6):1098–101. Scholar
  7. 7.
    Dumonceau JM, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2020;52(2):127–49.Google Scholar
  8. 8.
    Rey JF, et al. European Society of Gastrointestinal Endoscopy (ESGE) guideline: the use of electrosurgical units. Endoscopy. 2010;42:764–71.CrossRefGoogle Scholar
  9. 9.
    Coelho-Prabhu N, et al. Endoscopic retrograde cholangiopancreatography: utilisation and outcomes in a 10-year population-based cohort. BMJ Open. 2013;3:e002689.CrossRefGoogle Scholar
  10. 10.
    Masci E, et al. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001;96:417.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Gastroenterology, Hepatology und EndocrinologyRobert-Bosch-HospitalStuttgartGermany

Personalised recommendations