Background and aim: Imaging of aimed duct and performing of planned endoscopic therapy are unsuccessful
in 10–20% of endoscopic retrograde cholangiopancreatographies (ERCPs). The aim was
to evaluate the possibilities for improvement of successfulness in a prospective study.
Method: 84.0% out of 1012 ERCPs (including 41 cases of previous unsuccessful attempts of
other examiners) were performed successfully in last 3-yr-period. The causes of failure
were pyloric or duodenal stenosis in 26 patients (2.6%), duodenal diverticulum (DD)
in 25 patients (2.5%), Billroth II. partial gastrectomy (B II) in 19 patients (1.9%)
and others in 92 patients. Precut in 71 patients and pancreatic sphincterotomy (PEST)
in 10 patients were executed to improve the success rate.
Results: Precut and PEST enlarged the success rate of ERCPs with 6.8% to 90.8% (in DD from
72.8% to 80.4%, in B II from 48.8 to 59.5%). Complications occurred after precut in
2/72 cases were exsudative pancreatitis (EP) and in 6/71 cases hyperamylasemia (HA),
after PEST in 1/10 case EP and in 1/10 case HA.
Conclusion: Precut and PEST proved to be safe and effective to increase the success rate of ERCP.
