Initial experience with endoscopic retrograde cholangiopancreatography: the role in clinical practice.

A series of 62 patients referred for endoscopic retrograde cholangiopancreatography is reported. The pancreatic or biliary ductular systems were demonstrated in 42, the success rate of cannulation improving with experience. The technique was diagnostic in 25 of 31 patients referred with hepatobiliary problems and in 3 of 11 with suspected pancreatic pathology. In a further seven patients in this latter group the examination was helpful in management. Duodenoscopy, without duct cannulation, demonstrated carcinoma of the periampullary region in two patients. Pancreatitis occurred in two patients and cholangitis in one. There are few contra-indications to the examination which should be undertaken early in the investigation of patients with cholestasis.