CLINICAL OUTCOME OF ERCP IN HULL UNIVERSITY TEACHING HOSPITALS NHS TRUST

Aims Endoscopic retrograde cholangiopancreatography (ERCP) is predominantly performed as therapeutic procedure and carries substantial risk of complications when compared to other endoscopic procedures. British Society of Gastroenterology(BSG) in conjunction with Joint Advisory Group(JAG) for Gastrointestinal Endoscopy has recommended quality and safety guidelines for ERCP procedure. The purpose of audit was to compare our local ERCP practice to nationally agreed.

Methods This was a retrospective audit between 01/08/2018 and 31/01/2019. Data was collected from local endoscopy reporting system and clinical information system.

Results Total 173 patients underwent ERCP in 6 months. Average age was 69 years (range 18-96) while female to male ratio was 1.05(89 vs 84). CBD calculi was the most common indication (85%). Decompression of the intended duct was successful in 90% of the cases. Adverse events were reported in 9.2% (16/173) of the cases with post-ERCP pancreatitis been the most common complication i-e 5.7% (10/173). No perforation occurred. 2 patients died with in 30 days of the procedure (1 Severe Necrotising Pancreatitis, 1 Biliary sepsis). 8 days re-admission was 6.3%(11/173). Per rectal NSAIDs after ERCP was only given in 55% of the cases. Post-ERCP pancreatitis was more common among patients who did not received NSAIDs (i-e 6/76) at the time of ERCP compared to those who was given per rectal NSAID (i-e 4/97). 15%(27/173) of the patients were on anticoagulant/anti-platelets at the time of procedure which were all managed appropriately as per recommendations.

Conclusions Therapeutic success of ERCP and adverse events are similar to nationally reported. Variation in use of post-ERCP NSAIDs use was noted which has been highlighted to standardise practice.