Post-endoscopic retrograde cholangiopancreatography pancreatitis in single-stage endoscopic common bile duct stone removal.
ERCP
common bile duct stone
post‐ERCP pancreatitis
single‐stage endoscopic stone removal
Journal
JGH open : an open access journal of gastroenterology and hepatology
ISSN: 2397-9070
Titre abrégé: JGH Open
Pays: Australia
ID NLM: 101730833
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
20
12
2018
revised:
05
06
2019
accepted:
04
09
2019
entrez:
10
6
2020
pubmed:
10
6
2020
medline:
10
6
2020
Statut:
epublish
Résumé
Papillary treatment, such as endoscopic sphincterotomy or endoscopic papillary balloon dilation, and subsequent single-stage endoscopic stone removal are often performed for choledocholithiasis; however, the incidence of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) is unclear. This study aimed to compare the overall incidence of PEP between single- and two-stage stone removal groups and the incidence of PEP between these two groups based on cannulation time. We included 897 patients with native papilla who underwent papillary treatment and stone removal for choledocholithiasis with no inflammation or mild-to-moderate acute cholangitis at three institutions between April 2012 and March 2018 in Japan. We performed a propensity-matched analysis and regression adjustment by propensity score to adjust for potential confounding factors. In the propensity-matched analysis with 234 pairs, there was no significant difference in the overall incidence of PEP between single- and two-stage stone removal procedures (15/234, 6.4% Single-stage endoscopic stone removal after a long cannulation time of >15 min increased the incidence of PEP compared with the two-stage stone removal procedure. Thus, single-stage stone removal should be performed in patients with a cannulation time ≤ 15 min.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Papillary treatment, such as endoscopic sphincterotomy or endoscopic papillary balloon dilation, and subsequent single-stage endoscopic stone removal are often performed for choledocholithiasis; however, the incidence of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) is unclear. This study aimed to compare the overall incidence of PEP between single- and two-stage stone removal groups and the incidence of PEP between these two groups based on cannulation time.
METHODS
METHODS
We included 897 patients with native papilla who underwent papillary treatment and stone removal for choledocholithiasis with no inflammation or mild-to-moderate acute cholangitis at three institutions between April 2012 and March 2018 in Japan. We performed a propensity-matched analysis and regression adjustment by propensity score to adjust for potential confounding factors.
RESULTS
RESULTS
In the propensity-matched analysis with 234 pairs, there was no significant difference in the overall incidence of PEP between single- and two-stage stone removal procedures (15/234, 6.4%
CONCLUSIONS
CONCLUSIONS
Single-stage endoscopic stone removal after a long cannulation time of >15 min increased the incidence of PEP compared with the two-stage stone removal procedure. Thus, single-stage stone removal should be performed in patients with a cannulation time ≤ 15 min.
Identifiants
pubmed: 32514443
doi: 10.1002/jgh3.12263
pii: JGH312263
pmc: PMC7273691
doi:
Types de publication
Journal Article
Langues
eng
Pagination
394-399Informations de copyright
© 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
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