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Predictors of Technical and Clinical Success of ERCP in Patients with Biliary Obstruction: A Study from a Tertiary Referral Center in Indonesia

ACTA MEDICA INDONESIANA · Vol. 57 No. 4 (2025)

ISSN
2338-2732, 0125-9326
Terbit
2025-12-23
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic modality for managing malignant and benign biliary obstruction. Technical success (TS) and clinical success (CS) of modality are essential indicators of procedural efficacy, which is influenced by various patient- and procedure-related factors. Therefore, this study aims to evaluate the TS and CS rates of ERCP and identify their predictors in patients with biliary obstruction at a tertiary referral center in Indonesia. Methods: A retrospective analysis was conducted on patients with biliary obstruction who underwent therapeutic ERCP at Cipto Mangunkusumo Hospital between January 2022 and December 2024. Patients with diagnostic ERCP or prehepatic/parenchymal jaundice were excluded. Results: A total of 259 patients were included (49.4% female, mean age 50.6 years) in this study. The results show that the TS rate is 96.5%, with multivariate analysis identifying ulcerative fragile papillary mass (AOR 0.075; P=0.001) as an independent negative predictor. Meanwhile, the CS rate is 88%, with pre-ERCP bilirubin >3 mg/dL (AOR 8.545; P 3 mg/dL (OR 6.116; P=0.011). Conclusion: ERCP showed high technical and clinical success rates in managing biliary obstructions. TS was negatively predicted by ulcerative fragile papillary mass. CS was positively predicted by pre-ERCP bilirubin >3 mg/dL and negatively by prior stenting or pre-cutting. These findings should be taken into consideration when planning and delivering ERCP to achieve better outcomes.

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  • University of Indonesia
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Rudi PutrantoAfiliasi tidak diketahui25
Murdani AbdullahAfiliasi tidak diketahui12
Edward FaisalAfiliasi tidak diketahui11
Ikhwan RinaldiAfiliasi tidak diketahui11
Cleopas Martin RumendeAfiliasi tidak diketahui9
Siti SetiatiAfiliasi tidak diketahui8
Ari Fahrial SyamAfiliasi tidak diketahui8
Hasan MaulahelaAfiliasi tidak diketahui8
Em YunirUniversity of Indonesia6
Marcellus SimadibrataAfiliasi tidak diketahui6
Kaka RenaldiAfiliasi tidak diketahui6
Iris RengganisAfiliasi tidak diketahui4
Imam SubektiAfiliasi tidak diketahui4
Pringgodigdo NugrohoAfiliasi tidak diketahui4
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Cosphiadi IrawanAfiliasi tidak diketahui4
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Ari F SyamAfiliasi tidak diketahui4
Saskia Aziza NursyirwanAfiliasi tidak diketahui4
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Cleopas M RumendeAfiliasi tidak diketahui3
Nikko DarnindroAfiliasi tidak diketahui2
Dono AntonoAfiliasi tidak diketahui2
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Vera AbdullahAfiliasi tidak diketahui2
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Petrin R LukmanAfiliasi tidak diketahui2
Ika P WijayaAfiliasi tidak diketahui2

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Predictors of Technical and Clinical Success of ERCP in Patients with Biliary Obstruction: A Study from a Tertiary Referral Center in Indonesia</dc:title>
	<dc:creator>Darmadi, Tony</dc:creator>
	<dc:creator>Achmad Fauzi</dc:creator>
	<dc:creator>Dadang Makmun</dc:creator>
	<dc:creator>Hamzah Shatri</dc:creator>
	<dc:creator>Santoso, Djoa Theadora Rebecca </dc:creator>
	<dc:subject xml:lang="en-US">billiary obstruction</dc:subject>
	<dc:subject xml:lang="en-US">ERCP</dc:subject>
	<dc:subject xml:lang="en-US">technical success</dc:subject>
	<dc:subject xml:lang="en-US">clinical success</dc:subject>
	<dc:subject xml:lang="en-US">predictive factors</dc:subject>
	<dc:description xml:lang="en-US">Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic modality for managing malignant and benign biliary obstruction. Technical success (TS) and clinical success (CS) of modality are essential indicators of procedural efficacy, which is influenced by various patient- and procedure-related factors. Therefore, this study aims to evaluate the TS and CS rates of ERCP and identify their predictors in patients with biliary obstruction at a tertiary referral center in Indonesia. Methods: A retrospective analysis was conducted on patients with biliary obstruction who underwent therapeutic ERCP at Cipto Mangunkusumo Hospital between January 2022 and December 2024. Patients with diagnostic ERCP or prehepatic/parenchymal jaundice were excluded. Results: A total of 259 patients were included (49.4% female, mean age 50.6 years) in this study. The results show that the TS rate is 96.5%, with multivariate analysis identifying ulcerative fragile papillary mass (AOR 0.075; P=0.001) as an independent negative predictor. Meanwhile, the CS rate is 88%, with pre-ERCP bilirubin &amp;gt;3 mg/dL (AOR 8.545; P&amp;lt;0.001) and previous ERCP stenting/pre-cutting (AOR 0.330; P=0.037) being independent predictors. Distal malignant obstruction causes a higher pre-ERCP bilirubin level (P=0.025) of &amp;gt;3 mg/dL (OR 6.116; P=0.011). Conclusion: ERCP showed high technical and clinical success rates in managing biliary obstructions. TS was negatively predicted by ulcerative fragile papillary mass. CS was positively predicted by pre-ERCP bilirubin &amp;gt;3 mg/dL and negatively by prior stenting or pre-cutting. These findings should be taken into consideration when planning and delivering ERCP to achieve better outcomes.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-12-23</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/3068</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 4 (2025): Acta Medica Indonesiana; 474</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/3068/830</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Tony Darmadi, Achmad Fauzi, Dadang Makmun, Hamzah Shatri, Djoa Theadora Rebecca  Santoso</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>