Obstructive jaundice; diagnostic role of ERCP

Objective: To determine the efficacy of Endoscopic Retrograde Cholangiopancreatography [ERCP] in patients presenting with obstructive jaundice. DESIGN: Prospective study. Place and Duration of Study: This study was conducted at Military hospital Rawalpindi from 2000 to 2001, which is a tertiary referral centre for armed forces

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Patients and Methods: 50 patients were selected of both sexes for ERCP. Subjects of this study were patients who were diagnosed to have obstructive jaundice on the basis of laboratory investigations and sonography. Patients with less than 15 years of age and with conditions other than obstructive jaundice were not included. ERCP was carried out in left lateral position with the left arm held behind the back of the patient. The results were then prepared and analyzed by Fisher Exact test to find out significance between the ultrasound and ERCP

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Results: Successful ductal pacification was achieved in 45 cases. The gross pathological findings included 18 cases with stones, 11 cases with stricture and 12 cases with carcinoma. Only one case had choledochal cyst

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Conclusion: ERCP is a useful diagnostic tool, providing direct and non-surgical imaging of pancreatic and biliary ducts. It has improved the diagnostic yield and has proved to be more safe and economical mean of pre-operative assessment of obstructive jaundice without the need for more expensive CT scan / MRI or more invasive Per cutaneous Transhepatic Cholangiography [PTC]