COMPARATIVE OUTCOMES OF ERCP IN BENIGN VERSUS MALIGNANT BILIARY OBSTRUCTION

Background: The causes of biliary obstruction include choledocholithiasis, which is a non malignant condition, and malignant conditions like cholangiocarcinoma or pancreatic cancer. ERCP is a common procedure that is undertaken in diagnosing and managing these obstructions and depending on the type of obstruction, the results vary. Objectives: The purpose of this work is to assess the success rate, endoscopic modalities and complications of ERCP in cases of benign and malignant blockage of common bile duct. Study design : A prospective study Place and duration of study: July 2023 to December 2023 Jinnah Postgraduate Medical Centre, Karachi Gastroenterology Department. Methods: A prospective study was done in 100 patients of Biliary obstruction 50 benign and 50 malignant. After performing the ERCP on the patients, various factors were documented which include; success rate of the procedure, any adverse effects that may have occurred after the procedure and final results. Data analysis included using mean, standard deviation and ‘P’ value in order to determine the differences between the two groups. Results: In the benign group, the overall success rate of ERCP was 92 % and the overall complication rate was 8%. In the malignant group it was 78% of success and 18% complications. The length of the hospital stay was 3. 4 (±1. 1) for benign group and 5. 2 (±1. 5) days for the malignant group. There was found statistical significance of the complication rate difference, p=0. 03. Conclusions: ERCP is very beneficial in both primary benign and malignant biliary strictures, but patients with malignant strictures have greater complication rates and hospital stays than patients with benign strictures. Hence early management and rigorous screening of the patients involved will go a long way in ensuring better results are achieved.