Endoscopic Retrograde Cholangiopancreatography in an Australian Rural Centre: Outcomes and Benchmark‐Comparable Performance

Background Endoscopic retrograde cholangiopancreatography (ERCP) is a key therapeutic modality for biliary and pancreatic disease but carries recognised risks. While outcomes are well established in tertiary centres, data from rural Australian settings remain limited. This study aimed to evaluate ERCP outcomes in a rural centre and compare them with established quality benchmarks. Methods A retrospective clinical audit was conducted of all adult patients undergoing ERCP at a rural Victorian hospital between May 2024 and April 2026. Data were obtained from endoscopy reporting systems and electronic medical records. Primary outcomes were technical success and procedure‐related complications. Secondary outcomes included repeat ERCP, inter‐hospital transfer, 30‐day readmission and mortality. Results A total of 197 ERCPs were performed. Median age was 73 years (IQR 57–82), with 56% female patients. Most procedures were emergency (66%) and therapeutic (97.5%). Technical success was achieved in 92% of cases. Complications occurred in 5.6%, including post‐ERCP pancreatitis (3.6%), bleeding (1.5%) and perforation (0.5%), with no mortality. Failed ERCP (8%) required transfer to tertiary centres. Repeat ERCP was performed in 21.8% of cases, predominantly for planned staged interventions. Thirty‐day readmission was 0.5%. Conclusion ERCP in this rural centre demonstrates technical success and safety outcomes consistent with international benchmarks. These findings support the provision of ERCP in regional settings, with appropriate escalation pathways ensuring safe and effective care.