Audit of ERCP at Ibn Sina Hospital from 2009-2010

ABSTRACT

Surgeons are expected to deal with expect some failure of ERCP in extraction of missed CBD stones. Re-do surgery is difficult; however surgeons have to stand for it. To audit the outcome of ERCP in extraction of CBD stone for patients referred to Ibn Sina Teaching Hospital. This is prospective, hospital based study; carried in the period from January 2009 to June 2010 in Ibn Sina Teaching Hospital .A total of 119 patients referred for ERCP extraction of CBD stones were studied. Male to female ratio was 15. The mean age [ +/- SD] is 55.4 [ +/- 17.57]. Post cholecystectomy missed stones were 7[6%], post CDB exploration retained stones were 4[3.4%] and re-do ERCP was done in 9[7.6%] patients. Failure of stone extraction occurred in 10[25%] cases due to failure of cannulation while another 10[25%] cases had multiple impacted stones and nine [22.2%] had too big stone to be extracted. In addition, five [12.5%] cases had CBD stricture, and the procedure was not completed because of bleeding in two cases and impaction of the dormia basket in two [5%] cases. The success of redo ERCP is seven out of nine cases. Complication occurred in seven [5.88%] patients. These were bleeding in two [1.68%], cholangitis in one [0.84%] CBD and retro-peritoneal duodenal perforations in two [1.68%] and retained dormia basket in two [1.68%] cases. The mortality rate was one [0.8%] patient. ERCP, at Ibn Sina Hospital, has success rate in stone extraction in 79[66.4%] and complication rate in seven [5.88%] patients. About one third of cases attending ERCP for stone extraction were referred back for open exploration of CBD