Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases

  • Yoon Suk Lee (Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Jae-Young Jang (Department of Internal Medicine, Kyung Hee University Medical Center) ;
  • Jun Yong Bae (Department of Internal Medicine, Seoul Medical Center) ;
  • Eun Hye Oh (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Yehyun Park (Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Women's University College of Medicine) ;
  • Yong Hwan Kwon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Jeong Eun Shin (Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine) ;
  • Jun Kyu Lee (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Tae Hee Lee (Institute for Digestive Research and Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Chang Nyol Paik (Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2022.08.02
  • Accepted : 2022.09.23
  • Published : 2023.07.30
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Abstract

Background/Aims: This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability. Methods: Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs. Results: Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 3 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals. Conclusions: The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.

Keywords

Acknowledgement

We thank the Korean Medical Dispute Mediation and Arbitration Agency, which allowed the authors to review the database related to the medical disputes of pancreatobiliary endoscopy. This study was performed for the project commissioned by the Medical Dispute Mediation and Arbitration Agency in Korea from October 2020 to June 2021, titled "Analysis of the types and causes of gastrointestinal endoscopy-related medical accidents to make effective preventive measures".

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