Aim. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently used for the diagnosis and treatment of hepatic, biliary tract, and pancreatic disorders. However, failure during cannulation necessitates other interventions. The aim of this study was to establish parameters that can be used to predict failure during ERCP. Methods. A total of 5884 ERCP procedures performed on 5079 patients, between 1991 and 2006, were retrospectively evaluated. Results. Cannulation was possible in 4482 (88.2%) patients. For each one-year increase in age, the cannulation failure rate increased by 1.01-fold ( ). A history of previous hepatic biliary tract surgery caused the cannulation failure rate to decrease by 0.487-fold ( ). A tumor infiltrating the ampulla, the presence of pathology obstructing the gastrointestinal passage, and peptic ulcer increased the failure rate by 78-, 28-, and 3.47-fold, respectively ( ). Conclusions.Patient gender and duodenal diverticula do not influence the success of cannulation during ERCP. Billroth II and Roux-en-Y gastrojejunostomy surgeries, a benign or malignant obstruction of the gastrointestinal system, and duodenal ulcers decrease the cannulation success rate, whereas a history of previous hepatic biliary tract surgery increases it. Although all endoscopists had equal levels of experience, statistically significant differences were detected among them. 1. Introduction ERCP is a frequently used procedure for the diagnosis of biliary tract and pancreatic disorders. Following the first endoscopic cannulation of the ampulla of Vater by McCune, increasing experience and the technological developments in the field have enabled diagnostic and therapeutic uses of the procedure via interventions, such as sphincterotomy, biopsy of the biliary tract, extraction of calculi from the biliary tract, and stent placement, to provide temporary or permanent cures for biliary and pancreatic disorders [1–7]. Side-viewing endoscopes, supportive equipment, and improvements in visualization have helped to establish the current ERCP standards. However, difficulties imposed by the anatomy of the biliary tract and pancreas as well as the need for both an endoscopist and an endoscopy nurse with certain degrees of experience have made ERCP the most complicated, the most difficult to learn, the most interventional, and the most therapeutic of all endoscopic procedures [8]. Although the complication rates of ERCP are higher than those of other endoscopy procedures, they are markedly low compared to surgical interventions performed on the biliary tract and
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