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. 1990 Oct;31(10):1150–1155. doi: 10.1136/gut.31.10.1150

Future needs for ERCP: incidence of conditions leading to bile duct obstruction and requirements for diagnostic and therapeutic biliary procedures.

M W Gear 1, N A Dent 1, D G Colin-Jones 1, J H Lennard-Jones 1, J R Colley 1
PMCID: PMC1378741  PMID: 2083860

Abstract

Although the development of endoscopic methods of treatment for biliary obstruction has proceeded rapidly in recent years, endoscopic retrograde cholangiopancreatographic (ERCP) services are patchily distributed. A recent survey by the British Society of Gastroenterology has shown that almost half the district general hospitals questioned did not have a sphincterotomy service available locally. To assess the level of provision required, two investigations have been undertaken. Firstly, an epidemiological study of bile duct obstruction has been carried out in the South Western Region. Secondly, the actual surgical and endoscopic workload in treating obstructive jaundice has been analysed in two health districts. Using present incidence and treatment rates at least 50 ERCPs per 100,000 of the population per year are estimated to be required in the future. Surgical treatment rates can be expected to fall as the number of therapeutic ERCPs increases. The implications of this estimate in equipment and staffing terms are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Classen M., Demling L. Endoskopische Sphinkterotomie der Papilla Vateri und Steinextraktion aus dem Ductus choledochus. Dtsch Med Wochenschr. 1974 Mar 15;99(11):496–497. doi: 10.1055/s-0028-1107790. [DOI] [PubMed] [Google Scholar]
  2. Cotton P. B. Endoscopic management of bile duct stones; (apples and oranges). Gut. 1984 Jun;25(6):587–597. doi: 10.1136/gut.25.6.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Huibregtse K., Haverkamp H. J., Tytgat G. N. Transpapillary positioning of a large 3.2 mm biliary endoprosthesis. Endoscopy. 1981 Sep;13(5):217–219. doi: 10.1055/s-2007-1021688. [DOI] [PubMed] [Google Scholar]
  4. Little J. M. A prospective evaluation of computerized estimates of risk in the management of obstructive jaundice. Surgery. 1987 Sep;102(3):473–476. [PubMed] [Google Scholar]
  5. Neoptolemos J. P., Carr-Locke D. L., Fossard D. P. Prospective randomised study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones. Br Med J (Clin Res Ed) 1987 Feb 21;294(6570):470–474. doi: 10.1136/bmj.294.6570.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Neoptolemos J. P., Carr-Locke D. L., London N. J., Bailey I. A., James D., Fossard D. P. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet. 1988 Oct 29;2(8618):979–983. doi: 10.1016/s0140-6736(88)90740-4. [DOI] [PubMed] [Google Scholar]
  7. Robertson D. A., Ayres R., Hacking C. N., Shepherd H., Birch S., Wright R. Experience with a combined percutaneous and endoscopic approach to stent insertion in malignant obstructive jaundice. Lancet. 1987 Dec 19;2(8573):1449–1452. doi: 10.1016/s0140-6736(87)91141-x. [DOI] [PubMed] [Google Scholar]
  8. Shepherd H. A., Royle G., Ross A. P., Diba A., Arthur M., Colin-Jones D. Endoscopic biliary endoprosthesis in the palliation of malignant obstruction of the distal common bile duct: a randomized trial. Br J Surg. 1988 Dec;75(12):1166–1168. doi: 10.1002/bjs.1800751207. [DOI] [PubMed] [Google Scholar]
  9. Speer A. G., Cotton P. B., Russell R. C., Mason R. R., Hatfield A. R., Leung J. W., MacRae K. D., Houghton J., Lennon C. A. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet. 1987 Jul 11;2(8550):57–62. doi: 10.1016/s0140-6736(87)92733-4. [DOI] [PubMed] [Google Scholar]
  10. Summerfield J. A. Biliary obstruction is best managed by endoscopists. Gut. 1988 Jun;29(6):741–745. doi: 10.1136/gut.29.6.741. [DOI] [PMC free article] [PubMed] [Google Scholar]

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