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OBJECTIVE.The purpose ofour study was to determine the prevalence, distribution, and clinical Clinical indications for and therapy during ERCP were correlated with radiographic findings. RESULTS.Of the 94 patients with pancreas divisum, 54 (57%) had radiographic evidence of pancreatitis.Of these 54 patients, 44 had at least one episode of clinically documented pancreati- CONCLUSION.In our population ofpatients referred for ERCP and found to have pancreas divisum, the prevalence ofpancreatitis was very high and usually was limited to a dorsal distribution.Received October 29, 1998; accepted after revision January8, 1999.Presented at the annual meeting of the American

There are limited data on the outcome of emergency endoscopic retrograde cholangiopancreatography (ERCP) performed in the intensive care unit (ICU). We sought to assess the frequency, indications, and clinical outcomes of ERCPs performed in ICU patients who were too unstable to be transported to the endoscopy unit. An electronic endoscopy database was used to identify the patients (n = 22) and to assess procedural success, complications, and mortality. The indications for ERCP included suspected biliary sepsis, suspected gallstone pancreatitis, and known choledocholithiasis with cholangitis. Biliary cannulation, which was attempted in all patients, was successful in 19 patients (86 %), and of these 18 (95 %) underwent a technically successful endoscopic therapy. There were no apparent endoscopic complications. Therefore, emergency bedside ERCP in ICU patients, which is primarily performed for the management of suspected biliary sepsis and gallstone pancreatitis, can achieve high technical success rates when performed by experienced endoscopists, although the 30-day mortality rate remains high due to multiorgan dysfunction.