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A potential complication following endoscopic retrograde cholangiopancreatography: Subcapsular hepatic hematoma

Tsung-Hsun Yang, Kwei-Ming Chen, Shih-Wei Huang

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a technique with high success rate for diagnosis and treatment of biliary and pancreatic diseases, but haemorrhagic complications usually occurs when utilizing Endoscopic Sphincterotomy (EST) or Endoscopic Papillotomy (EPT). Here, we described the case of a 37-y-old female whose Common Bile Duct (CBD) stones were removed via ERCP and EPT due to dilated gallbladder and CBD obstruction. However, the patient suffered from subcapsular hepatic hematoma, sepsis, acute pancreatitis after ERCP. We arranged a second ERCP, Endoscopic Naso-Biliary Drainage (ENBD) and removed stones from gallbladder and junction of CBD and Common Hepatic Duct (CHD) by the Laparoscopic Common Bile Duct Exploration (LCBDE), as well as long-term antibiotic treatment. The patient then had a good condition of postoperative recovery. Hence, it should be alarming that subcapsular hepatic hematoma could be a potential complication post- ERCP and is life-threatening, and we provided the experience of utilizing a number of diagnostic techniques and a multidisciplinary approach of therapy strategies for resolving such complication successfully.