| Double guidewire technique vs transpancreatic precut sphincterotomy in difficult biliary cannulation. | |
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MedLine Citation:
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PMID: 23326171 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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AIM: To compare the outcomes between double-guidewire technique (DGT) and transpancreatic precut sphincterotomy (TPS) in patients with difficult biliary cannulation. METHODS: This was a prospective, randomized study conducted in single tertiary referral hospital in Korea. Between January 2005 and September 2010. A total of 71 patients, who bile duct cannulation was not possible and selective pancreatic duct cannulation was achieved, were randomized into DGT (n = 34) and TPS (n = 37) groups. DGT or TPS was done for selective biliary cannulation. We measured the technical success rates of biliary cannulation, median cannulation time, and procedure related complications. RESULTS: The distribution of patients after randomization was balanced, and both groups were comparable in baseline characteristics, except the higher percentage of endoscopic nasobiliary drainage in the DGT group (55.9% vs 13.5%, P < 0.001). Successful cannulation rate and mean cannulation times in DGT and TPS groups were 91.2% vs 91.9% and 14.1 ± 13.2 min vs 15.4 ± 17.9 min, P = 0.732, respectively. There was no significant difference between the two groups. The overall incidence of post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis was 38.2% vs 10.8%, P < 0.011 in the DGT group and the TPS group; post-procedure pancreatitis was significantly higher in the DGT group. But the overall incidence of post-ERCP hyperamylasemia was no significant difference between the two groups; DGT group vs TPS group: 14.7% vs 16.2%, P < 1.0. CONCLUSION: When free bile duct cannulation was difficult and selective pancreatic duct cannulation was achieved, DGT and TPS facilitated biliary cannulation and showed similar success rates. However, post-procedure pancreatitis was significantly higher in the DGT group. |
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Authors:
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Young Wook Yoo; Sang-Woo Cha; Woong Cheul Lee; Sae Hee Kim; Anna Kim; Young Deok Cho |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 19 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 108-14 Citation Subset: IM |
Affiliation:
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Young Wook Yoo, Department of Internal Medicine, Gastroenterology and Hepatobiliary Center, Cheongju St. Mary's Hospital, Cheongju 360-568, South Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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