Utility and safety of a new uneven double-lumen sphincterotome in cases of difficult biliary cannulation.
ERCP
Pancreatic guidewire method
Sphincterotome
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
04 Mar 2021
04 Mar 2021
Historique:
received:
23
07
2020
accepted:
24
02
2021
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
15
5
2021
Statut:
epublish
Résumé
We investigated the utility and safety of a new uneven double-lumen sphincterotome in biliary cannulation in comparison with the conventional pancreatic guidewire (PGW) method. We retrospectively evaluated 119 patients who required PGW placement because of difficult biliary cannulation. Endoscopic retrograde cholangiopancreatography (ERCP) was performed using a conventional ERCP catheter or a new uneven double-lumen sphincterotome. The success rate of bile duct cannulation, the operation time of bile duct cannulation, and the incidence of post-ERCP pancreatitis (PEP) were evaluated. Forty-four patients were treated with a new double-lumen sphincterotome (the new sphincterotome group) and 75 patients underwent conventional PGW placement (the conventional group). The success rate of bile duct cannulation was 39/44 (88.6%) in the new sphincterotome group and 63/75 (84.0%) in the conventional group (not significant). The total biliary cannulation time (from the reach to the papilla to the finish of biliary cannulation) was 16.0 (6.5-78) min in the new sphincterotome group and 26.0 (5-80) min in the conventional group (P < 0.01). The time from PGW placement to bile duct cannulation was 3.5 (0.3-57) min in the magictome group and 12.0 (1-65) min in the conventional group (P < 0.01). Hyperamylasemia was observed in 13/44 (29.5%) and 17/75 (22.7%), respectively (not significant). Five of 44 (11.3%) of the new sphincterotome group and 14/75 (18.7%) of the conventional group were diagnosed with PEP (not significant). A new double-lumen sphincterotome allows selective bile duct cannulation to be performed in a shorter time than the conventional PGW method.
Sections du résumé
BACKGROUND
BACKGROUND
We investigated the utility and safety of a new uneven double-lumen sphincterotome in biliary cannulation in comparison with the conventional pancreatic guidewire (PGW) method.
METHODS
METHODS
We retrospectively evaluated 119 patients who required PGW placement because of difficult biliary cannulation. Endoscopic retrograde cholangiopancreatography (ERCP) was performed using a conventional ERCP catheter or a new uneven double-lumen sphincterotome. The success rate of bile duct cannulation, the operation time of bile duct cannulation, and the incidence of post-ERCP pancreatitis (PEP) were evaluated.
RESULTS
RESULTS
Forty-four patients were treated with a new double-lumen sphincterotome (the new sphincterotome group) and 75 patients underwent conventional PGW placement (the conventional group). The success rate of bile duct cannulation was 39/44 (88.6%) in the new sphincterotome group and 63/75 (84.0%) in the conventional group (not significant). The total biliary cannulation time (from the reach to the papilla to the finish of biliary cannulation) was 16.0 (6.5-78) min in the new sphincterotome group and 26.0 (5-80) min in the conventional group (P < 0.01). The time from PGW placement to bile duct cannulation was 3.5 (0.3-57) min in the magictome group and 12.0 (1-65) min in the conventional group (P < 0.01). Hyperamylasemia was observed in 13/44 (29.5%) and 17/75 (22.7%), respectively (not significant). Five of 44 (11.3%) of the new sphincterotome group and 14/75 (18.7%) of the conventional group were diagnosed with PEP (not significant).
CONCLUSION
CONCLUSIONS
A new double-lumen sphincterotome allows selective bile duct cannulation to be performed in a shorter time than the conventional PGW method.
Identifiants
pubmed: 33663397
doi: 10.1186/s12876-021-01689-6
pii: 10.1186/s12876-021-01689-6
pmc: PMC7934518
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102Subventions
Organisme : KAKENHI
ID : JP18K08002
Références
Gastrointest Endosc. 2001 Jun;53(7):820-2
pubmed: 11375604
J Gastroenterol Hepatol. 2013 Nov;28(11):1787-93
pubmed: 23800118
Endoscopy. 2003 Jan;35(1):95-6
pubmed: 12510238
Endoscopy. 2015 May;47(5):421-9
pubmed: 25590186
Dig Endosc. 2018 Nov;30(6):808-809
pubmed: 30085367
Endoscopy. 2003 Sep;35(9):721-4
pubmed: 12929017
Gastrointest Endosc. 2012 Feb;75(2):339-46
pubmed: 22075192
World J Gastroenterol. 2008 Sep 28;14(36):5595-600; discussion 5599
pubmed: 18810780
Dig Endosc. 2018 Mar;30(2):149-173
pubmed: 29247546
J Gastroenterol. 2010 Nov;45(11):1183-91
pubmed: 20607310
J Gastroenterol. 2014 Feb;49(2):343-55
pubmed: 23612857
Surg Endosc. 2013 Feb;27(2):569-74
pubmed: 22926890
Pancreas. 1991 May;6(3):350-67
pubmed: 1713676
Gastrointest Endosc. 1991 May-Jun;37(3):383-93
pubmed: 2070995
Gastrointest Endosc. 2001 Oct;54(4):425-34
pubmed: 11577302
Endoscopy. 1998 Sep;30(7):S80
pubmed: 9826155
World J Gastroenterol. 2011 Dec 28;17(48):5289-94
pubmed: 22219598
Gastroenterol Rep (Oxf). 2015 Feb;3(1):32-40
pubmed: 25406464
Endoscopy. 2018 Aug;50(8):E229-E230
pubmed: 29895066