Comparison of Three Types of Precut Technique to Achieve Common Bile Duct Cannulation: A Retrospective Analysis of 274 Cases
| Autor: | Athanasios Beltsis, Anthi Gatopoulou, Sotiris Terzoudis, Stergios Gkagkalis, Georgia Lazaraki, Jannis Kountouras, Themistoklis Vasiliadis, Panagiotis Katsinelos, Grigoris Chatzimavroudis, Christos Zavos |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology MEDLINE digestive system Transplant surgery Internal medicine medicine Retrospective analysis Humans Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Common Bile Duct Common bile duct business.industry General surgery Gastroenterology Retrospective cohort study Middle Aged Hepatology humanities Sphincterotomy Transduodenal Surgery medicine.anatomical_structure Pancreatitis Female business |
| Zdroj: | Digestive Diseases and Sciences. 57:3286-3292 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-012-2271-8 |
| Popis: | The aim of this retrospective study was to evaluate the success rate and complications of three precut techniques of sphincterotomy after failure of conventional techniques of cannulation of common bile duct (CBD).Between January 2003 and October 2011, 2,903 consecutive ERCPs were performed in patients with naïve major papilla. In 283 patients in whom biliary cannulation was not achieved, precut technique was performed and these patients were included in the study.A total of 274 patients were included in the final analysis. Needle-knife papillotomy (NKP) was performed in 129 cases (47.1 %), suprapapillary fistulotomy (SPF) in 78 patients (28.5 %), and transpancreatic sphincterotomy (TPS) in 67 cases (24.5 %). No significant difference was observed in the initial and eventual success rate of biliary cannulation between the three groups. Overall, complications occurred in 54 patients (19.7 %), of which 33 (25.6 %) were with NKP, 6 (7.7 %) with SPF and 15 (22.4 %) with TPS, respectively, a difference statistically significant favoring the SPF group (p = 0.006). Post-procedure acute pancreatitis was developed in 27 cases (20.9 %) with NKP, compared to two cases (2.6 %) with SPF and 15 cases (22.4 %) with TPS, a difference statistically significant favoring the SPF group. No difference was observed between the groups with regard to the occurrence of post-procedure hemorrhage and perforation.The three types of precut sphincterotomy have no different overall CBD cannulation rates; SPF reduces post-ERCP pancreatitis risk. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink