Evaluating the Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Diagnosis and Management of Biliary Ascariasis: Clinical Outcomes and its Efficacy
DOI:
https://doi.org/10.63521/pjg.42.1.2026.20Keywords:
Biliary ascariasis, Endoscopic Retrograde Cholangiopancreatography , Ascaris lumbricoides, parasitic biliary disease, worm extraction, abdominal ultrasound, jaundice, tropical infections , diagnostic endoscopyAbstract
Background: Biliary ascariasis, caused by Ascaris lumbricoides invasion of the biliary tree, is a significant health concern in tropical regions like Pakistan. Although imaging plays a diagnostic role, Endoscopic Retrograde Cholangiopancreatography (ERCP) is increasingly employed for both diagnosis and treatment due to its minimally invasive nature.
Objective: This study aimed to evaluate the clinical efficacy, technical success, and outcomes of ERCP in managing biliary ascariasis.
Methods: A retrospective review of 29 cases of biliary ascariasis managed with ERCP between September 2017 and September 2024 was conducted at a tertiary care center in Karachi. Data on demographics, clinical presentation, imaging findings, procedural details, and outcomes were analyzed using SPSS v26.
Results: ERCP achieved a 100% technical success rate with no significant procedure-related complications or mortality. The most common symptoms were abdominal pain (100%) and jaundice (55.17%). Ultrasound identified worms in 41.3% of cases, while ERCP confirmed all. Adjunctive mebendazole therapy was administered post-procedure.
Conclusion: ERCP is a highly effective and safe modality for diagnosing and managing biliary ascariasis, reducing the need for invasive surgery. It should be considered the first-line intervention in endemic areas, supported by ant parasitic therapy to minimize recurrence.
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Copyright (c) 2026 Naseer Ahmed, Sania Maqbool, Muhammad Umair Tehseen, Pashmina Roohi, Muhammad Asim Sharif, Noval Zakaria, Abeer Altaf, Mehreen Siyal, Fahad Kakar, Asma Yaseen, Saad Khalid Niaz (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
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Authors retain the copyright to their work and grant the Pakistan Journal of Gastroenterology (PJG) the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
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