ERCP at a UK Hospital: A Cue for Developing Countries

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a combined endoscopic and fluoroscopic procedure for the investigation and therapy of disorders of the hepatobiliary and pancreatic system. The study aimed to determine the pattern of the patients who had ERCP at the Gastroenterology Department of Trafford General Hospital (TGH), Manchester UK as a cue for developing countries where the procedure is uncommon. A retrospective study of 240 adult patients who had ERCP was carried out between October 2002 and September 2007. Their biodata, clinical diagnoses as well as the different types of procedures carried out and the complications were reviewed. The subjects comprised 92 males and 148 females; and aged 66.4±16.6 and 61±17.2 years as mean ± standard deviation respectively. Forty three to fifty four patients had ERCP per year from October 2002 to September 2007. The gall bladder and biliary duct stone disease (42.5%) was the commonest indication observed among the patients. Single and multiple procedure(s) were carried at ERCP in 60% and 40% of the patients respectively. Out of the 105 patients that had complete data, normal cholangiopancreatography, dilated common bile duct and stricture of intra-hepatic bile duct were observed in 45.7%, 41.9%, and 2.9% respectively. Biopsies of the lesions of the bile duct, liver and Ampulla of Vater were carried out in 3.8%, while diagnosis and therapy of GI lesions were carried out in 5.7%. No death occurred among the 105 patients but complications such as pancreatitis, cholangitis, duodenal bleeding and perforation were observed in 2.9%, 0.9%, 1.9% and 0.9% respectively. Hence, biliary tree calculi were the commonest indications for ERCP and the major findings included normal examination and distended common bile duct. Single and multiple procedures were carried out during the procedure with few complications in attendance.