Can early precut reduce post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with difficult bile duct cannulation?

Autor:	Tanikawa T; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan. t-tanikawa@med.kawasaki-m.ac.jp., Miyake K; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Kawada M; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Ishii K; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Fushimi T; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Urata N; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Wada N; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Nishino K; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Suehiro M; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Kawanaka M; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Shiraha H; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Haruma K; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan., Kawamoto H; Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal endoscopy [World J Gastrointest Endosc] 2024 Sep 16; Vol. 16 (9), pp. 519-525.
DOI:	10.4253/wjge.v16.i9.519
Abstrakt:	Background: Endoscopic retrograde cholangiopancreatography (ERCP) is associated with a variety of adverse events (AEs). One of the most important AEs is post-ERCP pancreatitis (PEP), which is most common in cases of difficult biliary cannulation. Although the precut technique has been reported as a PEP risk factor, recent studies indicate that early precut could reduce PEP, and that precut itself is not a risk factor. Aim: To evaluate the safety of the precut technique, especially in terms of PEP. Methods: We conducted a retrospective study, spanning the period from November 2011 through December 2021. It included 1556 patients, aged ≥ 20 years, who underwent their initial ERCP attempt for biliary disease with a naïve papilla at the Kawasaki University General Medical Center. We compared the PEP risk between the early precut and the delayed precut group. Results: The PEP incidence rate did not significantly differ between the precut and non-precut groups. However, the PEP incidence was significantly lower in the early precut group than the delayed precut group (3.5% vs 10.5%; P = 0.02). The PEP incidence in the delayed precut group without pancreatic stent insertion (17.3%) was significantly higher compared to other cases ( P < 0.01). Conclusion: Our findings indicate that early precut may reduce PEP incidence. If the precut decision is delayed, a pancreatic stent should be inserted to prevent PEP. Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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