Endoscopic retrograde cholangiopancreatography in a general surgery practice

Endoscopic retrograde cholangiopancreatography (ERCP) is performed for the diagnosis and therapy of benign and malignant biliary and pancreatic disease. There are few reports in the literature regarding the incorporation of this procedure into a general surgery practice. One hundred seven consecutive ERCPs performed by the same surgeon over a two-year period were reviewed. The most frequent indications for ERCP were jaundice, suspected common bile duct stones, and a history of pancreatitis. Successful cannulation of the ampulla of Vater was achieved in 97 per cent of the cases with the desired duct being adequately visualized in 90 per cent of the cases. Sphincterotomy was performed in 42 per cent of the procedures and common bile duct stones were removed with a balloon or basket catheter. The overall complication rate was seven per cent with no mortality. ERCP accounted for 20 per cent of all endoscopies and 12 per cent of all procedures performed by the surgeon. Twelve per cent of these patients were subsequently operated upon by the surgeon while another 16 per cent requiring surgery were returned to the referring physician. This study supports the feasibility of the incorporation of ERCP into a general surgery practice.