title: ERCP in a cohort of 759 cases: A 6-year experience of a single tertiary centre in Libya.
abstract: OBJECTIVE
  The aim of this study was to review the indications, findings, technical success, and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a large cohort of patients admitted to a single tertiary centre in Libya.
  
  
  METHODS
  A total of 759 consecutive ERCP procedures were performed in 704 patients from January 2005 through December 2010 at the Endoscopy Unit of Central Hospital, Tripoli, Libya. The patients' demographic characteristics, clinical information, ERCP indications, laboratory parameters, and post-ERCP complications were reviewed. Formal written consent was obtained from all patients prior to each procedure.
  
  
  RESULTS
  The study included 280 (36.9%) males and 479 (63.1%) females with mean age ± standard deviation (SD) of 56.8 ± 18.7 years. Papillotomy was performed in 670 (88.3%) cases of the ERCP procedures. Common bile duct (CBD) stones were reported in 389 (51.3%) cases and were more frequent in females (234 cases, 60.1%) than males (155, 39.9%) (p = 0.01). The majority of the CBD stones were successfully retrieved with balloon extraction (304 cases, 78.2%), while mechanical lithotripsy (67 cases, 17.2%) and Dormia basket (11 cases, 2.8%) were used for difficult stones. Only seven (1.8%) cases were referred for surgery. Malignancy was found in 151 (19.9%) of the cases and was significantly more common in males than females (102, 67.5% vs. 49, 32.5%, respectively, p = 0.001). Stents for bile drainage were inserted in 26 (17.2%) of these cases. The complications encountered were acute pancreatitis in 30 cases (3.9%), minor bleeding in nine cases (1.2%), major bleeding in one case (0.15%), cholangitis in four cases (0.52%), and perforation in one case (0.15). Mortality was reported in three cases (0.4%).
  
  
  CONCLUSIONS
  The ERCP indications and the related complications, in our centre in Libya, are comparatively consistent with those reported data in other countries. Successful biliary cannulation was achieved in most of the patients, and post-ERCP complications were uncommon except for pancreatitis, which occurred more frequently.
authors.affiliation: Department of Medicine, Tripoli University, Tripoli, Libya.
authors.forename: Ali
authors.initials: A
authors.lastname: Tumi
authors.affiliation: Department of Medicine, Tripoli University, Tripoli, Libya.
authors.forename: Masoud
authors.initials: M
authors.lastname: Magadmi
authors.affiliation: Department of Medicine, Tripoli University, Tripoli, Libya.
authors.forename: Salah
authors.initials: S
authors.lastname: Elfageih
authors.affiliation: Department of Medicine, Tripoli University, Tripoli, Libya.
authors.forename: Abdul-Fatah
authors.initials: AF
authors.lastname: Rajab
authors.affiliation: Department of Medicine, Tripoli University, Tripoli, Libya.
authors.forename: Masoud
authors.initials: M
authors.lastname: Azzabi
authors.affiliation: Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar. Electronic address: nelzouki_1999@yahoo.com.
authors.forename: Abdel-Naser
authors.initials: AN
authors.lastname: Elzouki
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008002:Libya; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D016717:Sphincterotomy, Endoscopic / Q000379:methods; D062606:Tertiary Care Centers; D016896:Treatment Outcome