An Audit of ERCPS Performed in a Single Regional Referral Centre

Endoscopic retrograde cholangiopancreatography (ERCP) is a highly specialised procedure used in the diagnosis and treatment of a range of biliary and pancreatic diseases which might otherwise require surgical intervention. However, relatively high rates of complications (4–10%) including death (0.2–0.4%) have been reported.

Aims and Methods: We reviewed all ERCPs performed in our institution since the service was introduced in 1998. All procedures were performed by a single operator.

Results: 1775 ERCPs were performed between August 1998 and April 2004. 1497 patients (84.3% of total) were referred from hospitals in the southeast. Common bile duct stones were found in 41.2% of cases, malignancy 14.1%, pancreatitis 6.1% and other pathology 14.5%. 12.1% of examinations were normal while the procedure was unsuccessful in 11.9%. Sphincterotomy or fistulotomy was performed in 733 cases (41.3%) while 468 plastic and 98 metal stents (31.9%) were inserted. Complications: clinical pancreatitis developed in 8 (0.45%), no significant bleeding occurred and 5 patients (0.28%) died.

Conclusions: ERCP is a highly effective procedure in dealing with a range of biliary and pancreatic conditions, and in our experience it is associated with a considerably lower complication rate than has been reported.