| Autor: |
Kandemir, Altay, Taşkıran, İsmail, Coşkun, Adil, Yasa, Mehmet Hadi |
| Předmět: |
|
| Zdroj: |
Diagnostic & Interventional Endoscopy; Apr2023, Vol. 2 Issue 1, p5-8, 4p |
| Abstrakt: |
Objective: The precut sphincterotomy technique is widely used for difficult biliary cannulation during the endoscopic retrograde chola ngiop ancre atogr aphy procedure. Even though an accepted risk factor for post-endoscopic retrograde cholangiopancreatography is a risk factor for pancreatitis, there are numerous studies showing whether this risk is technique-related or due to prolonged procedure time and recurrent cannulation attempts. The study's primary aim was to evaluate the incidence of post-endoscopic retrograde chola ngiop ancre atogr aphy pancreatitis in early precut procedures compared to the standard technique in patients with difficult biliary cannulation. The secondary aim was to compare complications and cannulation success. Methods: In this prospective, single-center, randomized clinical trial, patients referred for therapeutic biliary endoscopic retrograde chola ngiop ancre atogr aphy and difficult biliary cannulation were divided into 2 groups. The first group was the early precut group (group A) and the second group was the late precut group (group B). Post-endoscopic retrograde chola ngiop ancre atogr aphy pancreatitis was defined as upper abdominal pain associated with at least a 3-fold rise in serum pancreatic enzymes above the normal level more than 24 hours after the procedure. Results: Three hundred patients were enrolled in the study. Nine of 150 patients (6%) in group A and 21 of 150 patients (14%) in group B developed postendoscopic retrograde chola ngiop ancre atogr aphy pancreatitis (odds ratio 2.33). Successful biliary cannulation without precutting was performed in 25 patients in group B, whereas delayed precutting was required in the remaining 125 patients. Compared to the delayed precut group (19/125, 15.2%), the incidence of postendoscopic retrograde chola ngiop ancre atogr aphy pancreatitis was significantly lower in the early precut group (9/150, 6%) (odds ratio 3.3). The "late precut" subgroup had a post-endoscopic retrograde chola ngiop ancre atogr aphy pancreatitis rate with an odds ratio of 2.5 compared to the group with cannulation without precut. These data suggest that the post-endoscopic retrograde chola ngiop ancre atogr aphy pancreatitis risk among patients who received a late precut was higher than among patients who had an early precut or could be cannulated after repetitive efforts. Conclusion: Early precutting is an effective technique for patients with challenging biliary tract cannulation and can significantly reduce post-endoscopic retrograde chola ngiop ancre atogr aphy pancreatitis incidence. Recurrent biliary cannulation attempts constitute a real risk factor for this complication. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
