Clinical, Endoscopic, and Outcome Characteristics of Patients with Head of Pancreas Cancer Undergoing ERCP

Background: Head of pancreas cancer frequently presents with obstructive jaundice secondary to malignant distal common bile duct stricture. Endoscopic retrograde cholangiopancreatography (ERCP) allows both biliary tract evaluation and biliary drainage via stent placement. Objective: To describe the clinical, endoscopic, radiological, and outcome characteristics of patients with head of pancreas cancer who underwent ERCP. Patients and Methods: A single-center descriptive study including 43 patients between January 2023 and January 2025 at the Mohammed V Military Instruction Hospital in Rabat. Demographic, clinical, biological, radiological, endoscopic data, and early post-procedure complications were analyzed. Results: The mean age was 67.2 ± 11.6 years, with a male predominance (79.1%). All patients presented with jaundice, and 41.9% had abdominal pain. Acute cholangitis was present at admission in 41.9% of patients. Mean total bilirubin was 167.4 ± 117.3 µmol/L. Main bile duct dilation was observed in 76.7% of patients, and distal common bile duct stricture in 67.4%. Technical success of ERCP was achieved in 30 patients (69.8%). A biliary stent was deployed in 32 patients (74.4%), predominantly plastic. The early complication rate was 11.6%, dominated by post-ERCP acute pancreatitis (7.0%). Conclusion: In this series, ERCP achieved biliary drainage in approximately 70% of patients with pancreatic head cancer. Procedural failure was mainly attributable to unsuccessful papillary cannulation. Early complications remained infrequent.