Hemorrhagic complications following endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is a fundamental therapeutic tool in pancreaticobiliary diseases. One of the serious complications following ERCP is hemorrhage with an incidence rate of approximately 1%-2%. Post-ERCP bleeding is primarily attributed to endoscopic sphincterotomy, which is an essential step to allow therapeutic maneuvers during ERCP. Less commonly, nonsphincterotomy-related bleeding has been reported. Several risk factors have been identified for post-ERCP bleeding, and preventive and therapeutic measures have been described. A better understanding of these complications is required by endoscopists to more efficiently prevent and manage them. In this article, we review the literature on post-ERCP bleeding and summarize its risk factors, grading and classification, and guidelines for prevention and management.