Pancreatic duct guidewire placement for biliary cannulation in a single-session therapeutic ERCP
| Autor: | Emmanouil Paraskevas, Dimitrios Dimitroulopoulos, Andreas Scorilas, D. Xinopoulos, Stefanos P. Bassioukas, Dimitrios Korkolis, Dimitrios Kypreos, Konstantinos Mavridis |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Brief Article Technical success Catheterization Sphincterotomy Endoscopic medicine Humans Favorable outcome Aged Retrospective Studies Pancreatic duct Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Gastroenterology Pancreatic Ducts Retrospective cohort study General Medicine medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Pancreatitis Female Radiology Bile Ducts business Single session Step method |
| Zdroj: | World journal of gastroenterology. 17(15) |
| ISSN: | 2219-2840 |
| Popis: | AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access. METHODS: During a five-year study period, a total of 2843 patients were included in this retrospective analysis. Initial biliary cannulation method consisted of single-guidewire technique (SGT) for up to 5 attempts, followed by double-guidewire technique (DGT) when repeated unintentional pancreatic duct cannulation had taken place. Pre-cut papillotomy technique was reserved for when DGT had failed or no pancreatic duct cannulation had been previously achieved. Main outcome measurements were defined as biliary cannulation success and post-endoscopic retrograde cholangiopancreatography (ERCP) complication rate. RESULTS: SGT (92.3% success rate) was characterized by statistically significant enhanced patient outcome compared to either the DGT (43.8%, P < 0.001), pre-cut failed DGT (73%, P < 0.001) or pre-cut as first step method (80.6%, P = 0.002). Pre-cut as first step method offered a statistically significantly more favorable outcome compared to the DGT (P < 0.001). The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner between either method (SGT: 5.3%, DGT: 6.1%, Pre-cut failed DGT: 7.9%, Pre-cut as first step: 7.5%) or with patients’ gender. CONCLUSION: Although DGT success rate proved not to be superior to SGT or pre-cut papillotomy, it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases. |
| Databáze: | OpenAIRE |
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