Document Detail

Pancreatic duct guidewire placement for biliary cannulation in a single-session therapeutic ERCP.
MedLine Citation:
PMID:  21528077     Owner:  NLM     Status:  MEDLINE    
AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access.
METHODS: During a five-year study period, a total of 2843 patients were included in this retrospective analysis. Initial biliary cannulation method consisted of single-guidewire technique (SGT) for up to 5 attempts, followed by double-guidewire technique (DGT) when repeated unintentional pancreatic duct cannulation had taken place. Pre-cut papillotomy technique was reserved for when DGT had failed or no pancreatic duct cannulation had been previously achieved. Main outcome measurements were defined as biliary cannulation success and post-endoscopic retrograde cholangiopancreatography (ERCP) complication rate.
RESULTS: SGT (92.3% success rate) was characterized by statistically significant enhanced patient outcome compared to either the DGT (43.8%, P < 0.001), pre-cut failed DGT (73%, P < 0.001) or pre-cut as first step method (80.6%, P = 0.002). Pre-cut as first step method offered a statistically significantly more favorable outcome compared to the DGT (P < 0.001). The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner between either method (SGT: 5.3%, DGT: 6.1%, Pre-cut failed DGT: 7.9%, Pre-cut as first step: 7.5%) or with patients' gender.
CONCLUSION: Although DGT success rate proved not to be superior to SGT or pre-cut papillotomy, it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases.
Dimitrios Xinopoulos; Stefanos P Bassioukas; Dimitrios Kypreos; Dimitrios Korkolis; Andreas Scorilas; Konstantinos Mavridis; Dimitrios Dimitroulopoulos; Emmanouil Paraskevas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  17     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-29     Completed Date:  2011-08-11     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1989-95     Citation Subset:  IM    
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MeSH Terms
Bile Ducts / surgery*
Catheterization / adverse effects,  methods*
Cholangiopancreatography, Endoscopic Retrograde / adverse effects,  instrumentation*,  methods*
Pancreatic Ducts / surgery*
Retrospective Studies
Sphincterotomy, Endoscopic / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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