Repeat ERCP

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 variety of things including the disease entities being treated, availability of the multiple endoscopic accessories, well trained support staff and the endoscopist’s skill and experience. Successful cannulation of the choledochus represents the foremost significant step of the diagnostic and therapeutic procedures. Cannulation procedure is reported to realize a hit rate of 80-95% when performed by experienced endoscopists. In cases where selective cannulation isn't feasible, generally precut papillotomy techniques are performed. However, various complications including pancreatitis, perforation and bleeding are more common upon the utilization of precut techniques. To reduce the ERCP-associated complication risk, it’s important to possess 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 cause a repeat examination, an alternate diagnostic assay , or follow-up clinical evaluation. Options for a repeat attempt include an equivalent endoscopist or a experienced endoscopist at a tertiary referral center. The objective of this retrospective study was to define the most lines of repeat ERCPs performed at our institutions endoscopy unit between the years 2006-2010; assess the explanations for repeat examination and present the results.