Lin Miao1, Quan-Peng Li1, Ming-Hui Zhu1, Xian-Xiu Ge1, Hong Yu1, Fei Wang1, Guo-Zhong Ji1. 1. Lin Miao, Quan-Peng Li, Xian-Xiu Ge, Hong Yu, Fei Wang, Guo-Zhong Ji, Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
Abstract
AIM: To evaluate the technique of transpancreatic septotomy (TS) for cannulating inaccessible common bile ducts in endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Between May 2012 and April 2013, 1074 patients were referred to our department for ERCP. We excluded 15 patients with previous Billroth II gastrectomy, Roux-en-Y anastomosis, duodenal stenosis, or duodenal papilla tumor. Among 1059 patients who underwent ERCP, there were 163 patients with difficult bile duct cannulation. Pancreatic guidewire or pancreatic duct plastic stent assistance allowed for successful ERCP completion in 94 patients. We retrospectively analyzed clinical data from 69 failed patients (36 transpancreatic septotomies and 33 needle-knife sphincterotomies). RESULTS: Of the 69 patients who underwent precut papillotomy, common bile duct cannulation was successfully achieved in 67. The success rates in the TS and needle knife sphincterotomy (NKS) groups were 97.2% (35/36) and 96.9% (32/33), respectively, which were not significantly different (P > 0.05). Complications occurred in 11 cases, including acute pancreatitis (n = 6), bleeding (n = 2), and cholangitis (n = 3). The total frequency of complications in the TS group was lower than that in the NKS group (8.3% vs 24.2%, P < 0.05). CONCLUSION: Pancreatic guidewire or pancreatic duct plastic stent assistance improves the success rate of selective bile duct cannulation in ERCP. TS and NKS markedly improve the success rate of selective bile duct cannulation in ERCP. TS precut is safer as compared with NKS.
AIM: To evaluate the technique of transpancreatic septotomy (TS) for cannulating inaccessible common bile ducts in endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Between May 2012 and April 2013, 1074 patients were referred to our department for ERCP. We excluded 15 patients with previous Billroth II gastrectomy, Roux-en-Y anastomosis, duodenal stenosis, or duodenal papilla tumor. Among 1059 patients who underwent ERCP, there were 163 patients with difficult bile duct cannulation. Pancreatic guidewire or pancreatic duct plastic stent assistance allowed for successful ERCP completion in 94 patients. We retrospectively analyzed clinical data from 69 failed patients (36 transpancreatic septotomies and 33 needle-knife sphincterotomies). RESULTS: Of the 69 patients who underwent precut papillotomy, common bile duct cannulation was successfully achieved in 67. The success rates in the TS and needle knife sphincterotomy (NKS) groups were 97.2% (35/36) and 96.9% (32/33), respectively, which were not significantly different (P > 0.05). Complications occurred in 11 cases, including acute pancreatitis (n = 6), bleeding (n = 2), and cholangitis (n = 3). The total frequency of complications in the TS group was lower than that in the NKS group (8.3% vs 24.2%, P < 0.05). CONCLUSION:Pancreatic guidewire or pancreatic duct plastic stent assistance improves the success rate of selective bile duct cannulation in ERCP. TS and NKS markedly improve the success rate of selective bile duct cannulation in ERCP. TS precut is safer as compared with NKS.
Authors: Calvin H Y Chan; Frank N Brennan; Matthew J Zimmerman; Donald G Ormonde; Spiro Costa Raftopoulos; Ian F Yusoff Journal: J Gastroenterol Hepatol Date: 2012-08 Impact factor: 4.029
Authors: V Cennamo; L Fuccio; R M Zagari; L H Eusebi; L Ceroni; L Laterza; C Fabbri; F Bazzoli Journal: Endoscopy Date: 2010-03-19 Impact factor: 10.093
Authors: Andreas Weber; Thomas Roesch; Sebastian Pointner; Peter Born; Bruno Neu; Alexander Meining; Roland M Schmid; Christian Prinz Journal: Pancreas Date: 2008-03 Impact factor: 3.327
Authors: Dániel Pécsi; Nelli Farkas; Péter Hegyi; Péter Varjú; Zsolt Szakács; Anna Fábián; Gábor Varga; Zoltán Rakonczay; Emese Réka Bálint; Bálint Erőss; József Czimmer; Zoltán Szepes; Áron Vincze Journal: Dig Dis Sci Date: 2019-05-04 Impact factor: 3.199