EFFICACY AND SAFETY IN LEFT LATERAL DECUBITUS VERSUS PRONE POSITION FOR ERCP: WHICH IS BETTER????

Aims:

To compare efficacy and safety of ERCP in the left lateral decubiitus position versus prone position.

Methods:

This was a retrospective, multicenter, open-label, observational study. A total of 652 ERCP were performed at four centers in Guayaquil, Ecuador between October 2013 and October 2017. Inclusion criteria. Age > 18 years, native papilla, and biliary indication. Exclusion criteria: coagulopathy, pregnancy. Primary outcome measure was bile duct cannulation rate. Secondary outcomes were a times to ampullary localization and bile duct cannulation and complication rate.

Results:

ERCPs reviewed from 652 patients in two positions: 426 prone and 226 LLD. Cannulation Rate. 96% prone versus 89% in left lateral decubitus position. Median times (IRQ):

1. Ampullary localization: 88sec (68 – 108) prone versus 95sec (75 – 115);

2. bile duct cannulation: 136sec (39 – 340) prone versus 155sec (50 – 405) left lateral decubitus.

No perioperative complications occurred in neither group. Postprocedure complications: 42 (10%) prone versus 34 (15%) left lateral decubitus position.

Conclusions:

Our results show that ERCP performed in left lateral decubitus position allowed for deep bile duct cannulation in 90% of patients without significantly increased procedural times or rate of complications as compared to prone position.