Outcome of Endoscopic Retrograde Cholangio-Pancreatography at Nobel Medical College Teaching Hospital: A Single Centre Experience

R. Yadav, K. Subedi, B. Purbey, M. Gautam, A. Bhattarai, A. Koirala
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Abstract

Background: Endoscopic retrograde cholangiopancreatography is a technically demanding endoscopic procedure for both diagnostic and therapeutic purpose in treating various pancreaticobiliary diseases. This service is very limited in tertiary care center of our country Nepal mostly limited to Kathmandu valley and Dhulikhel hospital. Materials and Methods: This is a descriptive cross-sectional study patients who underwent ERCP with therapeutic intent in Nobel Medical College Teaching Hospital, Biratnagar from April 2019 to April 2020. Total 148 patients were included in this study for analysis. Results: The most common finding was choledocholithiasis in 132(89.2%) patients. Benign biliary stricture was found in 7 (4.7%). Biliary obstruction due to periampullary growth was found in 7 (4.7%) patients. Bile duct injury was found in 1(0.7%) and chronic pancreatitis in 1 (0.7%) patient. The therapeutic success of ERCP was for choledocholithiasis, Stone Clearance in 1st attempt 68.9%, in multiple attempts18.2%, failed stone extraction in 3 cases (2.0%) only biliary stenting was done in 15 (10.3%) patients of various biliary disease for therapeutic and palliative reason. Pancreatic stenting was done in1 (0.7%) patient. The most common complication was Acute Pancreatitis in 6(4.1%), Post-Sphincterotomy bleeding in 1 (0.7%), biliary septic shock in 1 (0.7%) and 1 death (0.7%). Conclusion: ERCP can be continued in Nobel Medical College Teaching Hospital as it has lots of benefits with minimal acceptable complications.
诺贝尔医学院教学医院内镜逆行胰胆管造影的结果:单中心经验
背景:内镜逆行胰胆管造影是一项技术要求很高的内镜手术,对各种胰胆道疾病的诊断和治疗都有一定的要求。这项服务在我国尼泊尔的三级保健中心非常有限,主要局限于加德满都谷地和杜利赫勒医院。材料和方法:这是一项描述性横断面研究,患者于2019年4月至2020年4月在比拉特纳格尔诺贝尔医学院教学医院接受ERCP治疗。本研究共纳入148例患者进行分析。结果:132例(89.2%)患者以胆总管结石最为常见。良性胆道狭窄7例(4.7%)。7例(4.7%)患者因壶腹周围生长导致胆道梗阻。胆管损伤1例(0.7%),慢性胰腺炎1例(0.7%)。ERCP治疗胆总管结石的成功率为第一次结石清除率68.9%,多次结石清除率18.2%,结石取出失败3例(2.0%),仅因治疗和缓解原因对各种胆道疾病行胆道支架植入术15例(10.3%)。1例(0.7%)患者行胰腺支架植入术。最常见的并发症是急性胰腺炎6例(4.1%),括约肌切开后出血1例(0.7%),胆道感染性休克1例(0.7%)和死亡1例(0.7%)。结论:ERCP疗效显著,并发症少,可在诺贝尔医学院教学医院继续应用。
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