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Endoscopy 2006; 38(12): 1246-1249
DOI: 10.1055/s-2006-944970
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic retrograde cholangiopancreatography after pancreaticoduodenectomy for benign and malignant disease: indications and technical outcomes

J.  Farrell1 , D.  Carr-Locke1 , T.  Garrido1 , F.  Ruymann1 , S.  Shields1 , J.  Saltzman1
  • 1Division of Gastroenterology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
Further Information

Publication History

Submitted 7 March 2006

Accepted after revision 12 July 2006

Publication Date:
11 December 2006 (online)

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Background and study aims: Patients undergoing pancreaticoduodenectomy develop postoperative complications related to surgery and their disease. Very little data are available on the role or success of endoscopic retrograde cholangiopancreatography (ERCP) in such patients. The aim of this study was to evaluate the indications and role of diagnostic and therapeutic ERCP after pancreaticoduodenectomy for both benign and malignant disease.
Patients and methods: This study was a 10-year (1990 - 2000) single institution retrospective review of all ERCPs performed on patients who had undergone pancreaticoduodenectomy surgery. Indications for the ERCP and technical procedural success were studied.
Results: 29 patients with a pancreaticoduodenectomy underwent 56 ERCPs. Reasons for surgery were neoplasia and chronic pancreatitis. Indications for ERCP included evaluation of jaundice and pain. Technical success related to the clinical indication (jaundice 69 %, pain 54 %).
Conclusion: ERCP plays an important role in the management of postpancreatic surgery problems including biliary and anastomotic strictures, and should be the modality of choice. However, surgical technique may make the afferent limb inaccessible, and the ductal anastomosis difficult to identify in patients with some types of pancreaticoduodenectomy. Closer collaboration between surgeon and endoscopist may allow alterations in surgical technique to improve postoperative ERCP success.

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J. Farrell M. D.

Division of Digestive Diseases · UCLA School of Medicine

Los Angeles, CA 90405 · USA·

Fax: +1-310-794-9718

Email: jfarrell@mednet.ucla.edu

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