Contribution of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Treatment of Bilio-Pancreatic Pathologies: Experience from the Agadir Region
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a key technique for managing biliary and pancreatic diseases, combining endoscopy and radiology. Initially a diagnostic tool, ERCP is now primarily used for therapeutic interventions, supported by advancements in MRI and endoscopic ultrasound. Despite its effectiveness, ERCP carries risks that depend on patient conditions and procedural complexity. This study evaluates ERCP’s role in treating biliary diseases and associated complications in a regional setting. Materials and Methods: A retrospective study was conducted over four years (2020-2023) at Agadir Regional Hospital and Oued Eddahab Agadir Military Hospital. The study included all patients undergoing ERCP for biliary or pancreatic pathology. Data were collected from medical records, and statistical analysis was performed using Jamovi software. Results: A total of 77 patients were included, with a mean age of 62.1 years. The majority were women (sex ratio F/M = 1.3). The most common indication for ERCP was biliary lithiasis (75.3%), followed by tumor pathology (23.3%). Among tumor cases, pancreatic head adenocarcinoma (72.2%) was the most frequent, followed by cholangiocarcinoma. Management included metal (55%) and plastic (22%) stent placements. Biliary lithiasis was complicated by pancreatitis and/or cholangitis in 15.5% of cases. The bile duct was successfully catheterized in 93% of cases, with clearance achieved in 86.2% of patients. Complications were reported in 5% of cases, including mild pancreatitis, digestive perforation, and hemorrhage. One patient died due to pulmonary embolism. Conclusion: ERCP remains a crucial procedure for managing biliary and pancreatic diseases, particularly for lithiasis and tumor-related strictures. It allowed effective biliary drainage in tumor cases (77.8%) and successful bile duct clearance in 92.5% of lithiasis cases, with a low complication rate (5%).
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