Success Rate and Adverse Events of Endoscopic Retrograde Cholangiopancreatography in North of Iran

The efficacy of endoscopic retrograde cholangiopancreatography (ERCP) has increased significantly over time. However, there are few studies evaluating the success rate of ERCP in Iran.

We aimed to evaluate the success rate, adverse events, and mortality of ERCP in an academic medical center. This cross-sectional study was conducted over 2 years between February 2018 and January 2020 and 347 patients were enrolled. The success rates and causes of procedure failure were recorded by the endoscopists. The patients were followed up for all adverse events until discharge.

Eventually, 302 patients ended the study. The most common indication for ERCP was CBD stone (73.2%). The ERCP procedure was successful in 240 (79.5%) patients. Unsuccessful outcomes were due to cardiovascular conditions (n=7) and endoscopic problems (n=34). Of 34 cases of impossible cannulation, in 32 (10.6%) cases, the papilla was found but cannulation was not possible and in 2 (0.7%) cases it was not possible to access the papilla. The mean (SD) age of the patients with unsuccessful ERCP was significantly higher than successful cases (P=0.001). The times of cannulation, cannulation attempts, and dye injection were significantly higher in unsuccessful procedures as compared with successful procedures (P=0.014, P=0.001, and P=0.001, respectively). The mean time of cannulation (minute) was 5.05 in successful ERCPs and 11.99 in unsuccessful cases (P=0.014). Failure of ERCP was significantly associated with adverse events during ERCP (P=0.001). The most common adverse event was post-ERCP pancreatitis (PEP) (14.6%) and severe cases were 3.6%. PEP was significantly associated with sex (P=0.034). There was no mortality during the study.

We found that ERCP could be a safe and effective procedure, especially for patients under 65 years. The overall success rate and adverse events were compatible with the available data in the literature.