Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic modality in patients
with suspected biliary and pancreatic diseases. The diagnostic and therapeutic success of ERCP depends on a number of factors including
the disease entities being treated, availability of the multiple endoscopic accessories, well trained support staff and the endoscopistâs skill and
experience. Successful cannulation of the choledochus represents the most significant step of the diagnostic and therapeutic procedures.
Cannulation procedure is reported to achieve a success rate of 80-95% when performed by experienced endoscopists. In cases where
selective cannulation is not feasible, generally precut papillotomy techniques are performed. However, various complications including
pancreatitis, perforation and bleeding are more common upon the use of precut techniques. To reduce the ERCP-associated
complication risk, itâs important to have an experienced endoscopist, avoid unnecessary procedures, make adequate preparation before the
procedure and operate cautiously. The failure rate for cannulation of the duct of interest at ERCP ranges
from 5% to 15%. Depending on clinical indications, a failed first attempt may lead to a repeat examination, an alternative diagnostic test,
or follow-up clinical evaluation. Options for a repeat attempt include the same endoscopist or a more experienced endoscopist at a tertiary
referral center. The objective of this retrospective study was to define the main lines of repeat ERCPs performed at our institutionâs endoscopy unit between
the years 2006-2010; assess the reasons for repeat examination and present the results.
Last date updated on July, 2014