Analysis of Index ERCP Outcomes for Choledocholithiasis Cases in a Tertiary Care Hospital

Authors

  • Tanveer Hussain Gastroenterology department, Holy Family Hospital, Rawalpindi
  • Anum Abbas Gastroenterology department, Holy Family Hospital, Rawalpindi
  • Bushra Khar Department of Gastroenterology, Holy Family Hospital & Rawalpindi Medical University
  • Muhammad Umar Vice Chancellor RMU
  • Aqsa Naseer Gastroenterology department, Holy Family Hospital, Rawalpindi
  • Javeria Zahid Khan Gastroenterology department, Holy Family Hospital, Rawalpindi
  • Sadia Ahmed Department of Gastroenterology, Holy Family Hospital & Rawalpindi Medical University
  • Misbah Noureen Department of Gastroenterology, Holy Family Hospital & Rawalpindi Medical University

Abstract

Background: Bile duct stones (BDS) account for approximately 50% of cases necessitating endoscopic retrograde cholangiopancreatography (ERCP). Variability exists in stone clearance rates during ERCP, prompting different endoscopy societies to establish standards for expected clearance rates. This study aims to assess procedure outcomes at our tertiary care facility.

Patients and methods: This is a retrospective study conducted from January, 2021 to December 2023.  All patients with choledocholithiasis diagnosed on ultrasound abdomen or magnetic cholangiopancreatography with clinical symptoms were selected for ERCP. Data was collected from ERCP database.

Results: Of the 1878 ERCP procedures, 866 were for choledocholithiasis, with 763 being index ERCPs for this condition. Among these index ERCPs, 562 achieved successful stone retrieval and confirmed CBD clearance with occlusion cholangiogram in a single procedure (73.65%).  In remaining 201 index ERCP for choledocholithiasis, biliary plastic stenting was carried out in 184 (24.11%) due to different reasons.

Conclusions: In this study, clearing BDS rate at first ERCP is 73.65%. The difficult stones and common bile duct size are predominant factors responsible for index ERCP stone removal failure.

Published

2024-07-19

Issue

Section

Original Articles