Biliary cannulation effectiveness and pancreatitis risk using two early precut techniques.
| Autor: | de la Morena Madrigal EJ; Aparato Digestivo, Hospital La Zarzuela, ESPAÑA., Rodríguez García MªI; Aparato Digestivo, Hospital La Zarzuela., Galera Ródenas AB; Aparato Digestivo, Hospital La Zarzuela., Pérez Arellano E; Aparato Digestivo, Hospital La Zarzuela. |
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| Jazyk: | angličtina |
| Zdroj: | Revista espanola de enfermedades digestivas [Rev Esp Enferm Dig] 2018 Feb; Vol. 110 (2), pp. 74-81. |
| DOI: | 10.17235/reed.2017.5175/2017 |
| Abstrakt: | Introduction: Precut techniques allow for successful biliary cannulation rates approaching 100% but there may be an associated increase in the risk of complications. Recently, early needle-knife precut has been shown to be a safe procedure and is now used as a pancreatitis prevention resource for difficult cannulation cases. The goal of the present study was to assess cannulation and pancreatitis rates using two early precut techniques. Patients and Methods: This was a retrospective study of endoscopic retrograde cholangio-pancreatography (ERCP) procedures performed from 2013 to 2016. The efficacy and safety of simple cannulation, needle-knife precut and transpancreatic precut were assessed. Results: Simple cannulation was achieved in 369 (73.4%) of 503 evaluable ERCP procedures. Needle-knife precut was successful in 51 (96.2%) of 53 attempts and transpancreatic precut was successful in 75 (96.2%) of 78 attempts. The overall cannulation rate was 98.4%. There were eleven (2.4%) pancreatitis events, six (1.8%) with simple cannulation (two severe, one fatal), five (6.3%) with transpancreatic precut (two severe) and zero events with the needle-knife precut procedure. Among the patients undergoing the precut procedure, seven experienced perforations (two severe) and there were seven bleeding events. The overall complication rate was 14.4%. Conclusions: The complementary use of either precut technique provides a satisfactory biliary cannulation rate. However, the rates of pancreatitis and other severe complications are higher for transpancreatic versus needle-knife precut, therefore the indications for both techniques should be modified. |
| Databáze: | MEDLINE |
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