Assessment of ERCP maneuver in treatment of calcular obstructive jaundice

ABSTRACT

It was believed for a long period that ERCP has a relatively high rate of complications characterized by delayed onset of signs and symptoms of such complications [14] and [13]. This study performed upon 109 patients of calcular biliary obstruction subjected to E.R.C.P. in Al-Azhar university hospitals during the period from Dec. 1998 to Dec. 2002. for evaluation of ERCP procedure as a nonsurgical safe procedure for cleaning of biliary tract stones. The studied patients had been divided according to incidence of complications into complicated group[7 cases] and noncomplicated group [102 cases]. From 109 patients subjected to ERCP only 9 patients referred to surgical department, 85 patients treated by ballooning sweeping [83.3%], 8 patients treated by basket [7.8%] and in one patient the previous maneuvers had been failed and stenting was done [0.9]. So, ERCP procedure had been succeed in 101 patients from 109 [with success rate about 92.6%] for biliary system stone extraction. Only 7 patients from 109 studied patients have a complications [6.4%], Those with pallor and patients in whom cannulation was failed commoner than others for occurrence of complications, not this only but also, long duration of the procedure is the commonest cause of complications. Concluding the vitality of pre and post procedure clinical and laboratory assessment, as the complication can be minimized by careful patient selection, good preparation, experience of operator, and bed sided sticky follow up