Endoscopic retrograde cholangiopancreatography in a surgical unit.

The value of endoscopic retrograde cholangiopancreatography (ERCP) in a surgical unit was established by analysing 200 consecutive studies. The selective success rate was 80%. The groups of indications were jaundice (27%), postcholecystectomy pain (22%), recurrent acute pancreatitis (19%), complicated attack of acute pancreatitis (14%), and other (18%). A normal ERC was found and operation thus avoided in 26% of cases with persistent jaundice. In patients with postcholecystectomy pain pathological findings were found in 50% and half of them were operated upon. In pancreatitis demonstration of the pancreatic ducts and grading of the disease facilitated selection of the treatment and enabled preoperative planning of the surgical procedure. The pancreas was resected in 13 of 59 cases with diagnostic ERP. In pancreatic carcinoma ERCP led directly to diagnosis, but only two (ampullary carcinomas) out of ten were operable. The overall complication rate was 4%, including one case of fatal haemorrhagic pancreatitis.