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Predictive Factors for Failed Endoscopic Retrograde Cholangiopancreatography

Background: failure during cannulation renders the endoscopic retrograde cholangiopancreatography (ERCP) unsuccessful and gives rise to various consequences, including cholangitis and pancreatitis, which may require interventions, such as percutaneous transhepatic cholangiography (PTC) and surgery, with higher morbidities. Aim of the Work: we aimed to establish predictive factors for ERCP failure. Patients and Methods: a total of 103 ERCP procedures were done from October 2016 to October 2017 in the endoscopy unit at AL Hussein university hospital. Patients were divided according to ERCP results into 2 groups; group I consists of 93 cases of successful ERCP procedure (90.2%) and group II consists of 10 cases of failed ERCP procedure (9.7%). After clear written consent, full clinical, sonographic and laboratory evaluation were done for all patients. Results: patients with history of previous abdominal surgery andor CBD stricture had a significant higher rate of ERCP failure. Duodenal diverticula, papillary mass and gastric outlet obstruction were significantly higher in failed ERCP group. Conclusion: any patient with history of previous abdominal surgery, CBD stricture and benign or malignant tumors should be investigated before ERCP with non-invasive image as magnetic resonant cholangiopancreatography (MRCP) or Endoscopic ultrasound (EUS).