Failed biliary cannulation： Clinical and technical outcomes after tertiary referral endoscopic retrograde cholangiopancreatography

AIM： Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography （ERCP） for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS： Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2011-12, Vol.17 (45), p.4993-4998
Main Authors: Swan, Michael P, Bourke, Michael J, Williams, Stephen J, Alexander, Sina, Moss, Alan, Hope, Rick, Ruppin, David
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Brief
Catheterization - methods
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholangiopancreatography, Endoscopic Retrograde - methods
Female
Humans
Male
Middle Aged
Pancreatic Ducts - surgery
Prospective Studies
Referral and Consultation
Treatment Failure
Treatment Outcome
Young Adult
临床
内镜
平均年龄
技术成果
插管
胆总管结石
胆管
造影
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Summary:AIM： Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography （ERCP） for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS： Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS： Fifty-one patients （35 female; mean age： 62.5 years; age range： 40-87 years） with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis （45%） or pancreatic malignancy （18%）. Successful biliary can- nulation was 100%. The precut needle knife sphincterotomy （NKS） rate was 27.4%. Complications occurred in 3.9% （post-ERCP pancreatitis）. An identif iable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 nave pa-pilla patients （female 61%; mean age： 59.9 years; age range： 18-94 years） who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate （100% vs 98%） or postERCP pancreatitis （3.1% vs 3.9%）. Precut NKS use was more frequent （27.4% vs 12.7%） （P = 0.017）. CONCLUSION： Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i45.4993