Clinical utility of endoscopic retrograde cholangiopancreatography

Mark Topazian, R. Kozarek, R. Stoler, R. Vender, C. K. Wells, A. R. Feinstein

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: ERCP is a frequently performed procedure, but its necessity for diagnosis and ability to change management plans are unclear in many cases. Methods: We prospectively evaluated diagnosis, certainty of diagnosis, and management recommendations, both before and after ERCP, as well as therapeutic maneuvers performed during ERCP, in unselected patients undergoing this procedure. Results: ERCP procedures (1341) were studied at a university hospital, an ERCP referral center, and two community hospitals. Among patients undergoing first-time ERCP, the preceding clinical diagnosis was correct for 64% of those predicted to have bile duct stones, 86% to 89% of those given other biliary diagnoses, and 88% predicted to be normal. In 35% of cases, diagnostic confidence improved substantially after ERCP. Endoscopic therapy was successfully completed in 51%. After ERCP, plans for other invasive procedures changed in 82%: percutaneous biliary studies and open surgical procedures were recommended less often and laparoscopic cholecystectomy more often. Endoscopic therapy and overall clinical utility were most common in patients with cholangitis, jaundice, or bile leaks. Conclusions: ERCP is particularly helpful for diagnosis of bile duct stones but is less likely to change other diagnoses. The endoscopic therapy commonly carried out during ERCP often changes the treatment plan, leading to fewer surgical and percutaneous interventions in general, but more laparoscopic cholecystectomies.

Original languageEnglish (US)
Pages (from-to)393-399
Number of pages7
JournalGastrointestinal Endoscopy
Volume46
Issue number5
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Endoscopic Retrograde Cholangiopancreatography
Laparoscopic Cholecystectomy
Bile Ducts
Therapeutics
Cholangitis
Community Hospital
Jaundice
Bile
Referral and Consultation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Topazian, M., Kozarek, R., Stoler, R., Vender, R., Wells, C. K., & Feinstein, A. R. (1997). Clinical utility of endoscopic retrograde cholangiopancreatography. Gastrointestinal Endoscopy, 46(5), 393-399. https://doi.org/10.1016/S0016-5107(97)70030-0

Clinical utility of endoscopic retrograde cholangiopancreatography. / Topazian, Mark; Kozarek, R.; Stoler, R.; Vender, R.; Wells, C. K.; Feinstein, A. R.

In: Gastrointestinal Endoscopy, Vol. 46, No. 5, 01.01.1997, p. 393-399.

Research output: Contribution to journalArticle

Topazian, M, Kozarek, R, Stoler, R, Vender, R, Wells, CK & Feinstein, AR 1997, 'Clinical utility of endoscopic retrograde cholangiopancreatography', Gastrointestinal Endoscopy, vol. 46, no. 5, pp. 393-399. https://doi.org/10.1016/S0016-5107(97)70030-0
Topazian, Mark ; Kozarek, R. ; Stoler, R. ; Vender, R. ; Wells, C. K. ; Feinstein, A. R. / Clinical utility of endoscopic retrograde cholangiopancreatography. In: Gastrointestinal Endoscopy. 1997 ; Vol. 46, No. 5. pp. 393-399.
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