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Document Type

Original Article

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been recognized as a potential intervention for a range of pancreaticobiliary disorders. However, ERCP is limited by the incidence of failure or difficult cannulation. The current work aims to compare the safety of first-line vs. second-line maneuvers in difficult cannulation and identify the risks of ERCP failure among different patient indications.

Patient and Methods: The study was a prospective cohort study included adult patients who received ERCP treatment for different indications. The primary outcome was the rates of failed or difficult cannulation and the time to successful cannulation. Secondary outcomes were the rates complications associated with the procedure.

Results: Out of 231 ERCP patients assessed, eleven (4.76%) failed biliary cannulation. Failed cannulation was higher in patients with previously failed ERCP and malignant patients. Second-line techniques demonstrated a higher incidence of pancreatitis (p=0.004) and cholangitis (p=0.025). The mean cannulation time was comparable among the study groups (p=0.2).

Conclusion: Second-line techniques are more frequently implemented in malignant and previously failed ERCP cases. Second-line techniques has more risk of complications. Vigilant monitoring of patients treated with second line ERCP is strongly warranted.

Keywords

ERCP; Biliary; Endoscopic.

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