Abstract
BackgroundEndoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that is an essential tool in the management of pancreaticobiliary diseases. In the Arab world, there is limited data available on the indications and outcomes of ERCP. Therefore, we aimed to report the characteristics of patients, indications, and outcomes of ERCP from a tertiary referral center in Saudi Arabia.MethodsWe retrospectively looked at ERCP procedures done at a tertiary referral center covering the western region of Saudi Arabia from August 2018 till July 2020. Data were collected from the hospital’s electronic patient record and endoscopy database.ResultsOf 1001 ERCP’s performed, full data was available on 712 procedures on 581 patients that were included in the final analysis. Mean age was 53.1. 404 (56.7%) were female. All ERCPs were performed by certified consultants, with therapeutic intention. Sphincterotomy was performed in 563/581 (96.9%) patients who underwent first-ever ERCP. The commonest indication of ERCP was confirmed or suspected choledocholithiasis (52.6%), followed by replacement or removal of a biliary stent (15.7%), 55 (7.7%) for suspected ascending cholangitis, 54 (7.5%) for severe acute biliary pancreatitis, and 15 (2%) for suspected sphincter of Oddi dysfunction. The commonest finding among all patients was choledocholithiasis in 57.9%, debris in 15.2%, and biliary stricture in 14.8%. The commonest complication was pancreatitis 22/712 (3.1%) followed by post-sphincterotomy bleeding 16/712 (2.2%) and perforation 9/712 (1.2). Bleeding was controlled by endoscopic intervention in 4/16 (25%) and 1/16 (6.2%) patient underwent surgery. 2/712 (0.28%) patients had procedure-related mortality, one secondary to post-procedure pulmonary embolism and the other because of complicated perforation. The deeper CBD cannulation rate was 98.2% (570/581)ConclusionsOur study results revealed that ERCP performed in Saudi Arabia has similar indications and findings as compared to international literature. ERCP is successful in achieving the therapeutic objective with complication rates consistent with published literature.