PubMed · 10986200
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M D Hellier, A I Morris. 2000. ERCP training--time for change.. https://doi.org/10.1136/gut.47.4.459
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AIM: The aim of this prospective study was to audit all endoscopic retrograde cholangiopancreatographic (ERCP) procedures performed between July 1999 and November 1999, in particular to determine the spectrum and rate of complications. METHODS: An audit data sheet was designed with 100 variables on which the endoscopist recorded all the relevant details of the procedure, from patient demographics to overall success of the procedure. Data were collected at the time of ERCP and before discharge. Any complications within 30 days of ERCP were also recorded. RESULTS: Of 210 consecutive patients audited, successful diagnostic and therapeutic ERCP was performed in 93% with an overall complication rate of 9.5%. The incidence of pancreatitis was 4.76% and haemorrhage 2.38%. No severe complication or procedure-related mortality occurred. CONCLUSION: The most common complications of ERCP were pancreatitis and haemorrhage.
BACKGROUND: Indications for endoscopic retrograde cholangiopancreatography (ERCP) are not precisely defined. With the increasing availability of magnetic resonance cholangiopancreatography (MRCP) and several prospective studies proving the accuracy of this modality, it is important to select appropriate criteria for invasive testing when common bile duct (CBD) pathology is suspected. METHODS: We reviewed 200 consecutive ERCPs performed for jaundice, pancreatitis, noninvasive visualization of CBD stones, radiologic evidence of CBD dilatation, elevated liver function tests, or biliary colic. Diagnostic and therapeutic yields are determined for each indication and various combinations thereof. RESULTS: Of the 180 ERCPs performed for suspected choledocholithiasis, 97 (53.8%) were performed for multiple indications, whereas 83 (46.2%) were performed for only one indication. One hundred two patients (56.6%) had CBD pathology, whereas 78 explorations (43.4%) were negative. If multiple indications for ERCP were present, the diagnostic yield was 85.6%. When there was only one indication, the diagnostic yield decreased to 25.3%. CONCLUSIONS: ERCP is an invasive procedure with significant morbidity that should be used selectively. MRCP may be a more appropriate initial evaluation of suspected CBD pathology in many patients.
We herein report a case of pancreatic serous cystadenoma in a patient who presented with jaundice, and we provide a review of the literature. A 53-year-old man was admitted with complaints of jaundice and weight loss. With a preoperative diagnosis of pancreatic serous cystadenoma with obstructive jaundice, he underwent pylorus-preserving pancreatoduodenectomy. A cystic tumor partially protruding into the bile duct was observed in the pancreatic head. Histology verified serous cystadenoma of the pancreas. Histologically, no atypia was proven in the epithelium. There have been only eight case reports dealing with serous cystadenoma of the pancreas with obstructive jaundice. Although serous cystadenoma of the pancreas has essentially a benign nature, pylorus-preserving pancreatoduodenectomy is the treatment of choice when available to avoid the recurrence of obstructive jaundice.