OUR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATICOGRAPHY EXPERIENCES: SINGLE CENTER, 688 PATIENTS

2021 ◽  
Vol 6 (15) ◽  
pp. 115-121
Author(s):  
ERDEM SARI ◽  
Alpaslan Fedayi CALTA ◽  
Erdem SARI ◽  
Serhat OGUZ

Abstract Introduction and Aim: Successful ERCP requires deep cannulation of the common bile duct and/or the main pancreatic duct through the major duodenal papilla (papilla of Vater). Complications have been reported in cases of selective biliary cannulation, but this diminishes in experienced hands. The aim of this topic is to evaluate the practices and results in our clinic on how to achieve successful cannulation and sphincterotomy at minimum risk for the patient. Methods: The results of 688 patients who underwent ERCP in the endoscopy unit of our clinic over a 6-year period (2015-2021) are evaluated. Demographic findings, co-morbidities, duration of the procedure, presence of periampullary diverticulum, difficult cannulation rate, stent use, complication rate and successful cannulation rates of the patients were evaluated. Results: 58.5% of the patients were female. Heart diseases were found in 44.6% of the patients, kidney diseases in 11.5%, lung diseases in 14.9%, central nervous system diseases in 7.8% and malignancy in 2.1%. The common bile duct diameter is 12.98 ± 3.44 mm, and the mean stone size is 8.70 ± 4.50 mm. Periampullary diverticulum was present in 110 (15.9%) of the patients, and stony gall bladder was present in 48.0% of the patients. Selective cannulation was performed in 77.9% and pre-cut sphincterotomy was performed in 18.2%. Periampullary malignancy was detected in 12.1% of patients, and stent was applied to 22.1% of patients. Failed in 3.1% of patients. Emergency laparotomy was performed in 4 patients (0.6%). Bleeding was found in 58 patients (8.5%), perforation in five patients (0.8%), pancreatitis in 25 patients (4.0%), and mortality in six patients (1.0%). Conclusions: Although endoscopic retrograde cholangiopancreatography is an effective diagnostic and therapeutic tool, it can lead to serious complications. ERCP indication should be put correctly, procedures should be done by experienced people. In experienced hands, the success rate is high even with anatomical variations and difficult stones.

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.


1997 ◽  
Vol 78 (4) ◽  
pp. 299-301
Author(s):  
D. M. Krasilnikov ◽  
M. I. Mavrin ◽  
B. Kh. Kim

After endoscopic retrograde pancreatocholangiography, endoscopic nasobiliary drainage and removal of external drains in the postoperative period sometimes fragments of catheters remain in the common bile duct. The left foreign bodies contribute to cholangitis, pancreatitis, mechanical jaundice and concrements formation.


2019 ◽  
Vol 23 (4) ◽  
pp. 220-223
Author(s):  
M. Yu. Kozlov ◽  
Anton S. Malashenko ◽  
A. A. Shchebeteev

Choledocholithiasis is a rare pathology in children. Various techniques have been proposed for removing calculi from the common bile duct: percutaneous puncture drainage of bile ducts, endoscopic retrograde cholangiopancreatography with papillosphincterotomy as well as revision of the common bile duct which can be done laparoscopically or in the open abdomen. However at present, there is no any unified approach to managing this pahtology in children. The article describes authors’ experience of laparoscopic revision of the common bile duct in an infant with choledocholithiasis. The authors consider that this technique can be applied in pediatric surgical practice.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
V. O. Brunaldi ◽  
M. O. Brunaldi ◽  
R. Masagao ◽  
C. Silva ◽  
H. Masuda ◽  
...  

The incidence and prevalence of foreign body (FB) ingestion are difficult to estimate. Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. We report a case of a 73-year-old female patient presenting mid-term epigastric pain. Abdominal ultrasound revealed a slightly dilated common bile duct (CBD) and magnetic resonance showed an irregular filling failure in distal CBD and gallstones. Endoscopic Retrograde Cholangiopancreatography revealed major papilla on the edge of a diverticulum and confirmed the distal filling failure. After sphincterotomy, a partially intact toothpick was extracted from the CBD. Neither fistulas nor perforation signs were found. Literature related to foreign bodies and toothpick ingestion was reviewed and some hypotheses to explain the reported case were created. To our knowledge, this is the first report of a toothpick lodged inside the biliary tract.


2005 ◽  
Vol 71 (9) ◽  
pp. 750-753
Author(s):  
Gabriel Akopian ◽  
James Blitz ◽  
Thomas Vander Laan

The treatment of choledocholithiasis discovered incidentally during laparoscopic cholecystectomy is not yet standardized. Options include laparoscopic common bile duct exploration (LCBDE), postoperative endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy (ERCP-ES), and no intervention. We undertook a review of our case series to determine whether LCBDE is obligatory and which LCBDE method is unsuccessful. During the 6-year study period, 91 patients with choledocholithiasis were identified. Fifty-six patients (62%) underwent LCBDE. Thirteen (23%) of these 56 patients subsequently required ERCP. Balloon sweeping of the common bile duct failed in 10 of 21 patients (48% failure) compared to any other combination of techniques with a failure rate of 1/33 (3%; P < 0.001). Two patients did not undergo complete duct exploration because of technical problems. Thirty-five patients (38%) did not undergo LCBDE. Nine of these patients (26%) did not have ERCP-ES. None of the patients who underwent postoperative ERCP-ES required additional procedures or surgery. LCBDE can successfully treat common bile duct stones, with minimal to no morbidity, but is not mandatory for safely treating choledocholithiasis. Additionally, advanced techniques for clearing the common bile duct are more successful. Surgeons should be proficient at performing these techniques.


2019 ◽  
Vol 17 (Sup8) ◽  
pp. S8-S14
Author(s):  
Muhammad Waqas Fazal ◽  
Maria Tan ◽  
Shyam Menon

Endoscopic retrograde cholangiopancreatography (ERCP) facilitates endoscopic access to the common bile duct and pancreatic duct. It has become central to the management of a variety of benign and malignant pancreatobiliary disorders. ERCP remains a technically challenging procedure and patient selection and pre-assessment is critical to ensure good clinical outcomes. Staff assisting in ERCP should familiarise themselves with the underlying principles and basic knowledge pertaining to various aspects of ERCP.


2014 ◽  
Vol 38 (2) ◽  
pp. e31-e32 ◽  
Author(s):  
Fahd Ghalim ◽  
Abdullah Alatawi ◽  
Sarah Leblanc ◽  
Ariane Vienne ◽  
Marianne Gaudric ◽  
...  

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