Abstract

Wael. A. Shahin* and Hassan. A. Bokhary

Biliary disorders vary in different parts of the world. Study of endoscopic retrograde cholangiopancreatography (ERCP) cases gives an idea about the biliary disorders in the community. The aim of the study is to determine the characteristics of ERCP patients and predictors of common bile duct (CBD) stone in a tertiary hospital in Makkah, Saudi Arabia. This study was conducted on 135 patients admitted at Al Noor Specialist Hospital, Makkah, during the years 2009 and 2010. Patient demographics, presentation, liver function tests, comorbid conditions, ultrasound and ERCP findings were studied. The mean age of patients was 46.59 ± 17.6 yrs and female / male ratio was 1.56/1. Female patients were significantly younger, having more biliary colic (42.7 vs. 11.3%), biliary pancreatitis (11 vs. 3.8%), gall bladder stones (64.6 vs. 56.6%), history of cholecystectomy (12.2 vs. 5.7%) and less serum bilirubin (4.27± 3.95 vs. 9.73 ± 7.95), while male patients presented with obstructive jaundice more than female patients (84.9 vs. 46.3%). Pancreatico-biliary malignancy was found in jaundiced, diabetic patients older than 65 years. There was CBD stone in 56.3% of patients, CBD stones was significantly less in biliary pancreatitis patients (4 vs. 13.6%). Predictors of CBD stones were history of cholecystectomy, high alanine transaminase (ALT) and high alkaline phosphatase (ALP) serum levels. The sensitivity and specificity of abdominal ultrasound in detecting CBD stones were 69.5 and 88.1%. ERCP patients in Makkah are similar to patients in other areas of Saudi Arabia. No significant difference between Saudi and Non Saudi patients. Malignancy should be suspected in old age, diabetic, jaundiced patients. Biliary pancreatitis is more common in female patients with low incidence of CBD stones. Predictors of CBD stones are previous cholecystectomy, high ALT and high ALP serum levels. Abdominal ultrasound is still a good screening tool for CBD stones detection. Key words: Endoscopic retrograde cholangiopancreatography (ERCP), comm