ERCP In Management Of Congenital Biliary Dilatation In Adults

Aims To determine the role of ERCP in Treatment of CBD in adult patients.

Methods A retrospective descriptive study, including all adult patients presenting with CBD for a period of 4 years (March 2016- July 2020). Data regarding clinical presentation, investigations and management were analysed by SPSS.The type of cyst was classified according to Todani classification. All ERCP indications were validated in a multidisciplinary meeting.

Results 28 patients were included, median age was 64 years [38-89] with female predominance (Sex Ratio 4.5:1). Main symptoms were abdominal pain in 85.7 %, acute pancreatitis in 10.7 % and acute cholangitis in 10.7 % of cases. 78.9 % of pts had cholecystectomy for symptomatic Cholelithiasis. Elevated Liver tests were present in 46.4 % with increase bilirubin level in 32.1 %.Various imaging modalities (CT scan, MRCP) combined with endoscopic ultrasound allowed the diagnosis of CBD according to Todani classification: type I in 42 %, type III in7.1 %, type IV in 32.1 %, and type V in17.8 %. ERCP was performed in 46.4 %. Indications were: acute cholangitis in 92, 3 % and choledochocele treatment in 7, 1 %. CBD stones were found in 92, 3 %. Endoscopic Clearance of CBD was performed in 80 %.Endoscopic treatment of choledochocele was performed by endoscopic sphincterotomy after multidisciplinary discussion. No post-ERCP complications were reported and the mean fellow-up was 2,5 years . Surgical management was performed in 42.8 %. 66 % had cyst resection and roue en –Y- hepatico jejunostomy.33.3 % had cholecystectomy alone. Pathological results found no malignancies or premalignant lesion in all patients.

Conclusions In our study, indications of ERCP in patients with CBD were mainly acute cholangitis and choledochocele treatment . it remains a safe procedure with no complications in patients with CBD. No malignancies or premalignant lesions were found after CBD surgery.

Citation Taiymi A, El Moutaouakkil N, Kamaoui I M et al. eP349 ERCP IN MANAGEMENT OF CONGENITAL BILIARY DILATATION IN ADULTS. Endoscopy 2021; 53: S211.

Publication History

Article published online:
19 March 2021