Success of repeat ERCP by the same endoscopist

Gastrointest Endosc. 1999 Jan;49(1):58-61. doi: 10.1016/s0016-5107(99)70446-3.

Abstract

Background: The success rate of repeat endoscopic retrograde cholangiopancreatography (ERCP) by the same endoscopist after a failed initial attempt is unknown. It has been suggested that a repeat examination at a tertiary referral center be performed after an unsuccessful attempt. Our aim was to determine the success rate of repeat ERCP at a different endoscopic session by the same endoscopist and the outcomes among patients with a failed index procedure.

Methods: A review of 500 consecutive ERCP procedures was performed at a teaching institution.

Results: The overall initial success rate for cannulation of the duct of interest was 90.8% at index endoscopy. Endoscopy was repeated after 51% unsuccessful procedures, and access to the desired duct was achieved in 87.5% of repeat attempts. A needle knife was used in 21% instances, and its use facilitated cannulation of the duct of interest in 80%. No complications occurred with repeat ERCP. Of the 3 patients who underwent failed repeated ERCP, 1 was not available for the follow-up study, 1 had metastatic cancer, and the other had pancreas divisum. The outcomes among patients who did not undergo repeat ERCP included malignant disease diagnosed with other imaging techniques (35% of patients) and no further admissions or emergency room visits for suspected pancreaticobiliary symptoms (39% of patients).

Conclusions: Repeat ERCP by the same endoscopist yields an 87.5% success rate. This leads to an overall success rate of 95%.

Publication types

  • Comparative Study

MeSH terms

  • Bile Duct Diseases / diagnosis
  • Bile Duct Diseases / surgery*
  • Bile Ducts / diagnostic imaging
  • Bile Ducts / pathology
  • Bile Ducts / surgery*
  • Catheterization / statistics & numerical data
  • Cholangiopancreatography, Endoscopic Retrograde* / statistics & numerical data
  • Endoscopy, Digestive System
  • Endosonography
  • Follow-Up Studies
  • General Surgery / education
  • Hospitals, Teaching
  • Humans
  • Pancreatic Diseases / diagnosis
  • Pancreatic Diseases / surgery*
  • Pancreatic Ducts / diagnostic imaging
  • Pancreatic Ducts / surgery*
  • Reoperation / statistics & numerical data
  • Tomography, X-Ray Computed
  • Treatment Outcome