Effect of Precut Sphincterotomy on Biliary Cannulation Based on the Characteristics of the Major Duodenal Papilla

Horiuchi, Akira; Nakayama, Yoshiko; Kajiyama, Masashi; Tanaka, Naoki

doi:10.1016/j.cgh.2007.05.014

Cited by 59 publications

(67 citation statements)

References 16 publications

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“…The reported time limits within which the regularly used SBDC technique is used vary between 10 and 30 min [3][4][5][6][11][12][13]. The 15-to 30-min limits are used less consistently [14][15][16][17][18][19][20]. More refined methodology appears to be necessary to clarify the definition of the allocated procedure time regarding SBDC.…”

Section: Discussionmentioning

confidence: 99%

A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study

Kawakami

Maguchi

Mukai

et al. 2012

Gastrointestinal Endoscopy

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Background: Wire-guided cannulation (WGC) with a sphincterotome for selective bile duct cannulation (SBDC) has been reported to have a higher success rate and lower incidence of post-ERCP pancreatitis (PEP) than conventional methods in some randomized controlled trials (RCTs) that were both single-center and limited to only a few endoscopists.Objective: To estimate the difference in SBDC according to the method and catheter used in a multicenter and multi-endoscopist study. Design:A prospective multicenter RCT with a 2-by-2 factorial design. Setting: Fifteen referral endoscopy units.Patients: In total, 400 consecutive patients with naïve papilla who were candidates for ERCP were enrolled and randomized.Interventions: Patients were assigned to 4 groups according to combined catheter (sphincterotome (S) or catheter (C)) and method (with/without guidewire (GW)). Main Outcome Measurements:Success rate of SBDC in 10 min, time for SBDC, fluoroscopic time and incidence of complications. Results:There was no significant difference in SBDC success rate between with-and without-GW, between C and S, or between the 4 groups (C+GW, C, S+GW, and S). WGC had a tendency to significantly shorten cannulation and fluoroscopic times only in approximately 70% of patients in this study in whom SBDC was achieved in 10 min or less (P = 0.036 and 0.00004, respectively). All 4 groups resulted in similar outcomes in PEP (4%, 5.9%, 2%, and 2.1%, respectively).Limitations: Non-double-blinded study. Kawakami-4 4Conclusions: WGC appears to significantly shorten cannulation and fluoroscopic times.However, neither the method nor type of catheter used resulted in significant differences in either SBDC success rate or incidence of PEP in this RCT. Kawakami-5 5 Keywords:Wire-guided cannulation; Selective bile duct cannulation; Post-ERCP pancreatitis; Randomized controlled trial; Cannulation time; Fluoroscopic time; Radiation exposure time Kawakami-6 6 INTRODUCTIONBiliary cannulation is the most basic procedure for performing biliary interventions; however, no standard has been established to date. The success rates are considered to be related to 3 factors: the kind of catheter, cannulation method, and the skill of the endoscopist. The complication rates are also related to 3 factors: patient, procedure factors, and operator expertise. Cannulations using a sphincterotome with wire-guided cannulation (WGC) instead of the conventional catheter, with contrast medium injection, are gradually performed in many countries. These new methods were reported to be superior to conventional techniques in terms of both success rate and the incidence of post-ERCP pancreatitis (PEP) in some randomized studies [1][2][3][4][5]. However, those studies were performed by either a single or, at most, two skilled endoscopists in a single center [1,2,4,5]. Thus, these data cannot be generalized more widely.In these previous studies, 5° backward-oblique angle therapeutic duodenoscopes (BOAD) were used. In Japan, standard duodenoscopes have traditionally been 15° BOAD. Thu...

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Section: Discussionmentioning

confidence: 99%

A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study

Kawakami

Maguchi

Mukai

et al. 2012

Gastrointestinal Endoscopy

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“…Only in special cases of difficult cannulation due to anatomy, diverticula, lack of space or bulky papilla are extraordinary measures necessary [7,51] . The use of needle-knife precutting still remains the primary choice of most endoscopists in difficult cannulations.…”

Section: Resultsmentioning

confidence: 99%

“…The 15-to 30-min limits are used less consistently [7][8][9][10][11][12] . In addition to time, when defining difficulty the number of passages or contrast injections into the pancreatic duct must also be considered.…”

Section: Introductionmentioning

confidence: 99%

“…Even if those entries have occurred before the set time limit has expired, the procedure is recognized as being difficult cannulation [1,2,6,12,13] . Few reports have accepted multiple entries into the pancreatic duct within the time limit [7,10] . In several reports where the time was not specified, the only limiting factor was the number of allowed attempts on the papilla, between five and ten [14,15] .…”

Section: Introductionmentioning

confidence: 99%

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Management of difficult bile duct cannulation in ERCP

Udd

Kylänpää²,

Halttunen³

2010

WJGE

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In Encoscopic Retrograde Cholangiopancreatography (ERCP), the main concern is to gain access into the bile duct while avoiding the pancreatic duct because of the risk of post-ERCP pancreatitis. Difficult cannulation is defined as a situation where the endoscopist, using his/her regularly used cannulation technique, fails within a certain time limit or after a certain number of unsuccessful attempts. Different methods have been developed to manage difficult cannulation. The most common solution is to perform a precut papillotomy either with a needle knife or with a sphincterotome with or without a guide wire. This review describes different methods to overcome cases of difficult cannulation. We will discuss the success rate and complication rates associated with different methods of reaching the biliary tract.

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“…The ampulla of Vater appears as a hemispherical or oval elevation [1], although presentation varies among individuals. A typology for the shape of ampulla of Vater has not yet been established, but Horiuchi et al [2] have classified the exophytic type of ampulla of Vater based on shape into "small, large, or swollen." We did not determine the effect of the distal CBD cancer on the invaginated ampulla.…”

mentioning

confidence: 99%

Invaginated ampulla of Vater in synchronous malignant intraductal papillary mucinous neoplasm of the pancreas and common bile duct cancer

Han

Jang

et al. 2013

Endoscopy

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Effect of Precut Sphincterotomy on Biliary Cannulation Based on the Characteristics of the Major Duodenal Papilla

Cited by 59 publications

References 16 publications

A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study

A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study

Management of difficult bile duct cannulation in ERCP

Invaginated ampulla of Vater in synchronous malignant intraductal papillary mucinous neoplasm of the pancreas and common bile duct cancer

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