"Salvage techniques" are the key to overcome difficult biliary cannulation in endoscopic retrograde cholangiopancreatography

被引：7

作者：

Maruta, Shikiko ^{[1
]}

Sugiyama, Harutoshi ^{[1
]}

Ogasawara, Sadahisa ^{[1
,2
]}

Sugihara, Chihei ^{[1
]}

Ouchi, Mayu ^{[1
]}

Kan, Motoyasu ^{[1
]}

Yamada, Toshihito ^{[1
]}

Miura, Yoshifumi ^{[1
]}

Nagashima, Hiroki ^{[1
]}

Takahashi, Koji ^{[1
]}

Kusakabe, Yuko ^{[1
]}

Ohyama, Hiroshi ^{[1
]}

Okitsu, Koichiro ^{[1
]}

Ohno, Izumi ^{[1
]}

Mikata, Rintaro ^{[1
]}

Sakai, Yuji ^{[1
]}

Tsuyuguchi, Toshio ^{[3
]}

Kato, Jun ^{[1
]}

Kato, Naoya ^{[1
]}

机构：

[1] Chiba Univ, Grad Sch Med, Dept Gastroenterol, Inohana 1-8-1, Chiba 2608670, Japan

[2] Chiba Univ Hosp, Translat Res & Dev Ctr, Chiba, Japan

[3] Chiba Prefectural Sawara Hosp, Chiba, Japan

来源：

SCIENTIFIC REPORTS | 2022年 / 12卷 / 01期

关键词：

NEEDLE-KNIFE PRECUT; COMMON BILE-DUCT; TRANSPANCREATIC SPHINCTEROTOMY; ERCP; COMPLICATIONS; MULTICENTER; PAPILLOTOMY; DRAINAGE; SUCCESS;

D O I：

10.1038/s41598-022-17809-5

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Although the efficacy and safety of salvage techniques for biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) have been reported, few reports analyzed the choice of techniques and their clinical outcomes in large cohorts. This study aimed to evaluate the outcomes of biliary cannulation in patients with native papillae. We retrospectively identified 1021 patients who underwent initial ERCP from January 2013 to March 2020. We investigated background factors, treatment details, cannulation success rates, and adverse event rates. Then we analyzed a series of treatment processes, including salvage techniques such as double guidewire technique (DGT), needle knife pre-cutting (NKP), and transpancreatic pre-cut papillotomy (TPPP). The initial ERCP success rate using standard technique alone was 62.8%, which increased to 94.3% including salvage techniques. Salvage techniques were frequently required in patients with long oral protrusions (OR 2.38; 95% CI 1.80-3.15; p < 0.001). A total of 503 cases (49.3%) had long oral protrusions, 47.5% of which required the salvage techniques, much higher than 27.5% of not-long cases. Patients with long oral protrusions had a higher frequency of NKP. In conclusion, patients with long oral protrusions frequently required salvage techniques. Salvage techniques may help to overcome many difficult biliary cannulation cases.

引用

页数：10

共 31 条

[31] Comparison of sequential pancreatic duct guidewire placement technique and needle knife precut sphincterotomy for difficult biliary cannulation [J].

Zou, Xiao Ping ;

Leung, Joseph W. ;

Li, Yun Hong ;

Yao, Yu Ling ;

Pei, Qing Shan ;

Wu, Yu Lin ;

He, Qi Bin ;

Cao, Jun ;

Ding, Xi Wei .

JOURNAL OF DIGESTIVE DISEASES, 2015, 16 (12) :741-746

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