Comparison of Three Types of Precut Technique to Achieve Common Bile Duct Cannulation: A Retrospective Analysis of 274 Cases

Katsinelos, Panagiotis; Gkagkalis, Stergios; Chatzimavroudis, Grigoris; Beltsis, Athanasios; Terzoudis, Sotiris; Zavos, Christos; Gatopoulou, Anthi; Lazaraki, Georgia; Vasiliadis, Themistoklis; Kountouras, Jannis

doi:10.1007/s10620-012-2271-8

Cited by 77 publications

(74 citation statements)

References 20 publications

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“…Lower PEP rate was observed in early precut group (5.4% vs 12.1%) . If the patient with common bile duct dilation down to the papilla, some studies suggested fistulotomy is the preferred precut technique …”

Section: Risk Factorsmentioning

confidence: 99%

Postendoscopic retrograde cholangiopancreatography pancreatitis

Shih

Hsu

Kuo

2019

The Kaohsiung J of Med Scie

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Endoscopic retrograde cholangiopancreatography (ERCP) has been a mainstay examination to clarify the biliary and pancreatic system. Not just diagnostic purpose, it could achieve therapeutic goal. Under the trend of more and more procedures about ERCP being interventional, the rate of adverse events after the procedure is increasing. Among them, post‐ERCP pancreatitis (PEP) is the most common and sometimes tremendous complication. This mini‐review will overview the PEP from definition, pathogenesis, and risk factors to prevention.

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Section: Risk Factorsmentioning

confidence: 99%

Postendoscopic retrograde cholangiopancreatography pancreatitis

Shih

Hsu

Kuo

2019

The Kaohsiung J of Med Scie

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“…81 In a retrospective analysis of patients in which > 80% had pancreatography but only 10% underwent pancreatic stenting, risk of PEP was low (3%) after NKF compared to either NKS or TPP that was associated with a high risk for PEP (> 20%). 82 Jin et al 83 recently reported no cases of PEP when NKF was utilized as a primary access technique before any standard cannulation methods in patients with bile duct stones. However, the risk of NKF is likely higher in patients with small diameter bile ducts.…”

Section: Procedures Techniquesmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…If feasible, a prophylactic pancreatic stent should be placed as there is a significant risk of PEP. There are also potential long-term consequences of a pancreatic sphincterotomy, such as pancreatic orifice stenosis [8]. • Intramural incision technique: This technique utilizes the false tract that can be created by the guide wire during biliary cannulation attempts.…”

Section: Less Common Precut Techniquesmentioning

confidence: 99%

When standard cannulation approaches fail

Lakhtakia

Holt

2014

Ercp

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principles of biliary accessThe principle of selective biliary cannulation is akin to a skilled firefighter (endoscopist) who has to enter a building (bile duct) to evacuate trapped residents (obstructive pathology). Unlocking the latches at the entry gate (standard cannulation) should be the first attempt to enter the building without bothering the neighbor (pancreas). Trying to break in (traumatic cannulation attempts) or repeated knocking at the neighbor's door (pancreatic injections) can complicate the situation (post-ERCP pancreatitis (PEP)). If the neighbor's (pancreas) gate opens first, it is prudent to evacuate him (prophylactic pancreatic duct (PD) stent) to limit damage. Once successful entry is gained into the building (selective bile duct cannulation) the doors can be opened (sphincterotomy) to enable entry of fire extinguishers (accessories) to facilitate the exit of trapped residents (obstructed bile). If entry from the main gate to the building is not possible, a drill can be used Key points• Selective cannulation is almost always achievable by experts using standard methods in patients with normal anatomy and no major pathology in the region of the papilla.• When difficulties arise, deep biliary cannulation is best attempted using double guide wire and needle-knife techniques (best over a pancreatic stent).• Rendezvous approaches allow endoscopic retrograde cholangiopancreatography (ERCP) after a guide wire has been passed antegradely through the papilla via the transhepatic route, or with endoscopic ultrasound (EUS).• Patients with surgically altered biliary anatomy are increasingly common and pose the greatest challenges.• These advanced techniques carry significant risks.

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Comparison of Three Types of Precut Technique to Achieve Common Bile Duct Cannulation: A Retrospective Analysis of 274 Cases

Abstract: The three types of precut sphincterotomy have no different overall CBD cannulation rates; SPF reduces post-ERCP pancreatitis risk.

Cited by 77 publications

References 20 publications

Postendoscopic retrograde cholangiopancreatography pancreatitis

Postendoscopic retrograde cholangiopancreatography pancreatitis

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

When standard cannulation approaches fail

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