ArticleDigestive diseases and sciences2026
Is the Success Rate of Endoscopic Retrograde Cholangiopancreatography (ERCP) ± Sphincterotomy Done for Bile Duct Stones Optimal?
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Biliary stent migration after cholecystectomy following a single-preoperative ERCP: insights into real-world bile duct management.Surgical endoscopy · 2026Article
- Endoscopic Retrograde Cholangiopancreatography (ERCP) Under the Spotlight.Digestive diseases and sciences · 2026Article
- Safety and outcomes of laparoscopic bile duct exploration: a UK-wide multi-centre study (R-ALiCE).Surgical endoscopy · 2026Article
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Authors and funding
7 authors.
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Abstract
backgroundEndoscopic Retrograde Cholangiopancreatography (ERCP) is the standard treatment for bile duct stones (BDS). While reported success rates often exceed 80%, the literature rarely distinguishes between success at the index ERCP and cumulative success across multiple procedures. Moreover, definitions of ERCP success vary significantly.
aimThis study evaluates the index ERCP's success rates according to pre-defined criteria.
methodsA retrospective review of all ERCPs performed for BDS before cholecystectomy at University Hospitals Plymouth (2009-2023). Primary outcomes included bile duct clearance at index ERCP, post-procedural complications, stone recurrence, and mortality.
resultsA total of 1,436 patients, median age 72 years (20-94), underwent 1853 ERCPs for BDS. The bile duct cannulation and clearance rates were 93.5% and 70.9%, respectively. The main reasons for procedure failure were incomplete stone removal (12.3%) and anatomical challenges (7.1%). Among the cohort, 22.8% required repeat ERCPs. The complication rate was 4.8% (pancreatitis = 1.7%, biliary sepsis = 1.5%, bleeding = 1.3% and perforation = 0.4%). The BDS recurrence rate was 9.8% and the median time to recurrence was 7 months (1-112). On multivariate analysis, male sex was the only risk factor for stone recurrence (OR:2.242,95%CI:1.304-3.853, P = 0.003). All patients with post-ERCP complications were admitted to the hospital, and their median hospital stay was seven days (1-306). The 90-day mortality rate was 2.1%.
conclusionIn our study, index ERCP achieved stone clearance in 70.9% of cases, with a quarter of patients needing a repeat procedure. Patients should be appropriately consented to and informed of the success rate of ERCP and alternative treatment options, such as intraoperative imaging followed by bile duct exploration and cholecystectomy for surgically fit patients.
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