Frequency and Causes of Failed Endoscopic Retrograde Cholangiopancreatography in AL-Rajhi Endoscopy Unit

were abnormal variation in papilla (53.6%) and infiltrated papilla (28.6%) followed by altered anatomy with previous surgery in 4 (14.3%) patients and large juxa-papillary diverticulum in one patient. Based on the current study, predictors of failed cannulation of major papilla were endoscopists experience < 5 years and malignant obstruction. Conclusion: ERCP still has some sort of difficulty during canulation. Early prediction of those patients who are vulnerable to failure of cannulation would have a great effect on their outcome with a reduction in the frequency of expected complications. Frequent multicenter studies are warranted to confirm such results.