Complications of Therapeutic Endoscopy: A Review of the Incidence, Risk Factors, Prevention, and Endoscopic Management

Endoscopic complications were thought to be on the decline with more flexible endoscopes, new devices, and increased endoscopist experience. However, endoscopy has concurrently changed from mainly a diagnostic to a therapeutic modality. With these trends, complications such as bleeding and perforation continue to occur, especially during therapeutic procedures. Understanding and minimizing the risk factors that predispose to certain complications may prevent their occurrence. In addition, there are effective preventative endoscopic strategies that decrease the risk of complications. The past management of these serious complications has primarily been surgical. However, there has been a significant trend toward the use of endoscopic modalities to manage some of these serious complications. The incidences, risk factors, and management approaches to bleeding, perforation, and stricturing related to esophagogastroduodenoscopy, colonoscopy, and endoscopic retrograde will be reviewed. The discussion will focus primarily on endoluminal approaches to complication prevention and management.