Endoscopic retrograde cholangiopancreatography results and reliability in experienced hands

Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging modality that visualizes biliary tract and pancreatic ductus after giving contrast material by cannulation of ampulla vateri via a duodenoscope. It has been used in the diagnosis and treatment of pancreatic ductus and biliary tract. This study included 204 patients. There was stone formation at ductus choledochus in 147 (72.06%), malignant biliary stricture in 28 (13.73%), benign biliary stricture in 8 (3.92%), periampullary tumor in 4 (1.96%), hydatid cyst communicating with ductus choledochus in 2 (0.98%), fasciola hepatica in 1 (0.49%), sclerosing cholangitis in 4 (1.96%), sphincter of Oddi dysfunction in 5 (2.45%) and postoperative bile leakage in 3 (1.47%) of the patients. The procedure couldn’t be performed in 2(0.98%) patients due to anatomic difficulties. Stone retrieval with basket and/or balloon was performed in 115 (56.37%) patients while plastic stents was inserted to ductus choledochus in 87 (47.64%) and in pancreatic ductus in 5 (2.45%) patients. Mechanical lithotripsy was performed in 6 (2.94%) patients. Following ERCP, pancreatitis was developed in 3 (1.47%) patients, whereas sepsis in 2(0.98%) and bleeding in another 2 (0.98%) patients. ERCP remains to be an effective method in the diagnosis and treatment of biliary tract and pancreatic ductus in experienced hands.

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Chandrasekhara V, Khashab MA, Muthusamy VR, et al. Adverse events associated with ERCP. Gastrointest Endosc. 2017;85:32-47.

Turan M, Karadayı K, Duman M, ark. Endoskopik retrograd kolanjiopankreatografi (ERKP) deneyimimiz. C.Ü Tıp Fak Derg. 2003;25:171-6.

Kim J. Training in Endoscopy: Endoscopic Retrograde Cholangiopancreatography. Clin Endosc. 2017;50:334-9.

Classen M, Demling L. Endoscopic sphincterotomy of thepapilla of vater and extraction of Stones from the choledochal duct. Dtsch Med Wochenschr. 1974;99:496-7.

Coelho-Prabhu N, Shah ND, Van Houten H, et al. Endoscopic retrograde cholangiopancreatography: utilisation and outcomes in a 10-year populationbasedcohort. BMJ Open. 2013;3.

Prat F, Malak NA, Pelletier G, et al. Biliary symptoms and complications more than 8 years after endoscopic sphincterotomy for choledocholithiasis. Gastroenterology. 1996;110:894-9.

Cohen S, Bacon BR, Berlin JA, et al. National institutes of health state of-thescience conference statement: ERCP for diagnosis and therapy. Gastrointest Endosc. 2002;56:803-9.

Acar F, Şahin M, Yılmaz H, ark. Endoskopik Retrograt Kolanjiopankreatikografi Deneyimlerimiz. Selçuk Tıp Derg. 2014;30:111-4.

Ceylan G, Yavaşçaoğlu B, Kofralı G, ark. Endoskopik retrograd kolanjiopankreatografi işlemi için bilinçli sedasyon uygulamasında propofol ile deksmedetomidinin hemodinami ve kognitif fonksiyonlara etkisinin karşılaştırılması. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2010;36:103-10.

Jowell PS, Baillie J, Branch MS, et al. Quantitative assessment of procedural competence. A prospectivestudy of training in endoscopic retrograde cholangiopancreatography. Ann Intern Med. 1996;125:983-9.

Chutkan RK, Ahmad AS, Cohen J, et al. ERCP corecurriculum. Gastrointest Endosc. 2006;63:361-76.

Shahidi N, Ou G, Telford J, et al. When trainees reach competency in performing ERCP: a systematic review. Gastrointest Endosc. 2015;81:133742.

Rabenstein T, Schneider HT, Nicklas M, et al. Impact of skill and experience of the endoscopist on the outcome of endoscopic sphincterotomy techniques. Gastrointest Endosc. 1999;50:628-36.

Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335:909-18.

Koçkar MC, Şenol A, Cüre E, ark. Endoskopik retrograd kolanjiyopankreatografi deneyimi: prospektif çalışma. Nobel medicus. 2009;5:10-3.

Cotton PB. Outcomes of endoscopy procedures: struggling towards definitions. Gastrointest Endosc. 1994;40:514-8.

Mallery JS, Baron TH, Dominitz JA, et al. Complications of ERCP Gastrointest Endosc. 2003;57:633-8.

Basat O, Köklü S, Çiçek B, ark. Endoskopik retrograd kolanjiopankreatografi komplikasyonları: Tek merkezli retrospektif çalışma. Akademik gastroenteroloji Dergisi. 2006;5:169-72.

Mutlu N, Bolat R, Yorulmaz F, ark. Endoskopik retrograd kolanjiopankreatografi (ERCP). Güncel Gastroenteroloji. 2005;10:120-3.

Ödemiş B, Kuzu UB, Öztaş E, ark. Endoscopic management of the difficult bile duct stones: A single tertiary center experience. Gastroenterol Res Pract. 2016;2016:8749583.

Chan AC, Ng EK, Chung SC, et al. Common bile duct stones becom emsaller after endoscopic biliary stenting. Endoscopy. 1998;30:356-9.

Geyik MF, Kara İH, İnce N, ark. ERCP sonrası bakteriyemi ile mortal seyreden klatskin tümörü olgusu. Konuralp Tıp Dergisi. 2015;7:118-20.

Wiggers K, Koerkamp BG , Coelen RJ, et al. Preoperative biliary drainage in perihilar cholangiocarcinoma: identifying patients who require percutaneous drainage after failed endoscopic drainage. Endoscopy. 2015;47:1124-31.