Aims
Exploring the Outcomes and safty from a multicentre UK series of LA-ERCPs performed across five centres located in the Northeast of UK.
Methods
Retrospective multicentre case series of consecutive patients undergoing LA-ERCP between September 2020 up to August 2025 at Northumbria, Sunderland, Freeman, NorthTees and Jamescook Hospitals. Thirty-eight consecutive patients undergoing LA-ERCP were included. Data were collected on demographics, indications, imaging, baseline bloods, procedural success, adverse events, and hospital stay. Technical success was defined as successful cannulation of the papilla; therapeutic success was defined as successful stone removal or other definitive intervention.
Results
A total of 38 LA-ERCPs were performed. The median age was 59 years (IQR 54-67). The cohort was predominantly female (23/38, 60.5%). Common indications included choledocholithiasis and cholangitis. Pre-procedure MRCP was performed in the majority of cases. Median bilirubin was 16.5 µmol/L (IQR 12-54.5) and ALP 286.5 U/L (IQR 173-625.5).
Technical success (cannulation) was achieved in 37/38 (97.4%) cases with a single case of successful cannulation but unsafe sphincterotomy . Therapeutic success (stone removal) was achieved in 33/38 (86.8%) cases. Three cases (7.9%) were classified as procedure failure, which included the failed sphincterotomy case and two cases that required subsequent surgical management despite initial cannulation.
Complications included pancreatitis (1 case, 2.6%), bleeding (2 cases, 5.3%), and surgical adverse events (1 case, 2.6%). No cases of post-ERCP cholangitis or perforation were recorded. The median length of stay was 2 days (IQR 1–4).
|
Outcome |
Count/Total |
Rate (%) |
|
Technical Success (Cannulation) |
37/38 |
97.4% |
|
Therapeutic Success (Stone Removal) |
33/38 |
86.8% |
|
Procedure Failure |
3/38 |
7.9% |
|
Post-ERCP Pancreatitis |
1/38 |
2.6% |
|
Bleeding |
2/38 |
5.3% |
|
Perforation |
0/38 |
0.0% |
|
Cholangitis |
0/38 |
0.0% |
|
Surgical Adverse Events |
1/38 |
2.6% |
Conclusions
In this multicentre UK series in the Northeast, LA-ERCP demonstrates a very high technical success rate (97.4%) and an acceptable therapeutic success rate. The complication profile is favorable, with low rates of post-ERCP pancreatitis and bleeding, and no perforations. LA-ERCP offers a reliable and safe alternative for biliary access post-RYGB in centers with appropriate expertise.