Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones
Background/Aims Difficult biliary cannulation is an important risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Therefore, this study aimed to identify the factors that predict difficult cannulation for common bile duct stones (CBDS) to reduce the risk fo...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2022-03-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-153.pdf |
| _version_ | 1797422856316911616 |
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| author | Hirokazu Saito Yoshihiro Kadono Takashi Shono Kentaro Kamikawa Atsushi Urata Jiro Nasu Haruo Imamura Ikuo Matsushita Tatsuyuki Kakuma Shuji Tada |
| author_facet | Hirokazu Saito Yoshihiro Kadono Takashi Shono Kentaro Kamikawa Atsushi Urata Jiro Nasu Haruo Imamura Ikuo Matsushita Tatsuyuki Kakuma Shuji Tada |
| author_sort | Hirokazu Saito |
| collection | DOAJ |
| description | Background/Aims Difficult biliary cannulation is an important risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Therefore, this study aimed to identify the factors that predict difficult cannulation for common bile duct stones (CBDS) to reduce the risk for PEP. Methods This multicenter retrospective study included 1,406 consecutive patients with native papillae who underwent ERCP for CBDS. Factors predicting difficult cannulation for CBDS were identified using univariate and multivariate analyses. Results Univariate analysis showed that six factors significantly predicted difficult cannulation: ERCP performed by non-expert endoscopists, low-volume center, absence of acute cholangitis, normal serum bilirubin, intradiverticular papilla, and type of major duodenal papilla. Multivariate analysis identified ERCP performed by non-expert endoscopists (odds ratio [OR], 2.5; p<0.001), low-volume center (OR, 1.6; p<0.001), intradiverticular papilla (OR, 1.3; p=0.007), normal serum bilirubin (OR, 1.3; p=0.038), and absence of acute cholangitis (OR, 1.3; p=0.049) as factors significantly predicting difficult cannulation for CBDS. Conclusions Initial cannulation by an experienced endoscopist, early rescue cannulation, or early takeover by an experienced endoscopist should be considered when performing ERCP for CBDS in the presence of factors predicting difficult cannulation. |
| first_indexed | 2024-03-09T07:39:27Z |
| format | Article |
| id | doaj.art-83b06e2927d44836a008a93da11899a3 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:39:27Z |
| publishDate | 2022-03-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-83b06e2927d44836a008a93da11899a32023-12-03T05:03:19ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-03-0155226326910.5946/ce.2021.1537585Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct StonesHirokazu Saito0Yoshihiro Kadono1Takashi Shono2Kentaro Kamikawa3Atsushi Urata4Jiro Nasu5Haruo Imamura6Ikuo Matsushita7Tatsuyuki Kakuma8Shuji Tada9 Department of Gastroenterology, Kumamoto City Hospital, Kumamoto, Japan Department of Gastroenterology, Tsuruta Hospital, Kumamoto, Japan Department of Gastroenterology, Kumamoto Chuo Hospital, Kumamoto, Japan Department of Gastroenterology, Saiseikai Kumamoto Hospital, Kumamoto, Japan Department of Gastroenterology, Saiseikai Kumamoto Hospital, Kumamoto, Japan Department of Gastroenterological Surgery, Kumamoto Chuo Hospital, Kumamoto, Japan Department of Gastroenterology, Saiseikai Kumamoto Hospital, Kumamoto, Japan Department of Gastroenterology, Kumamoto Chuo Hospital, Kumamoto, Japan Department of Biostatics Center, Medical School, Kurume University, Fukuoka, Japan Department of Gastroenterology, Kumamoto City Hospital, Kumamoto, JapanBackground/Aims Difficult biliary cannulation is an important risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Therefore, this study aimed to identify the factors that predict difficult cannulation for common bile duct stones (CBDS) to reduce the risk for PEP. Methods This multicenter retrospective study included 1,406 consecutive patients with native papillae who underwent ERCP for CBDS. Factors predicting difficult cannulation for CBDS were identified using univariate and multivariate analyses. Results Univariate analysis showed that six factors significantly predicted difficult cannulation: ERCP performed by non-expert endoscopists, low-volume center, absence of acute cholangitis, normal serum bilirubin, intradiverticular papilla, and type of major duodenal papilla. Multivariate analysis identified ERCP performed by non-expert endoscopists (odds ratio [OR], 2.5; p<0.001), low-volume center (OR, 1.6; p<0.001), intradiverticular papilla (OR, 1.3; p=0.007), normal serum bilirubin (OR, 1.3; p=0.038), and absence of acute cholangitis (OR, 1.3; p=0.049) as factors significantly predicting difficult cannulation for CBDS. Conclusions Initial cannulation by an experienced endoscopist, early rescue cannulation, or early takeover by an experienced endoscopist should be considered when performing ERCP for CBDS in the presence of factors predicting difficult cannulation.http://www.e-ce.org/upload/pdf/ce-2021-153.pdfcommon bile duct stonecannulationendoscopic retrograde cholangiopancreatographyfactor |
| spellingShingle | Hirokazu Saito Yoshihiro Kadono Takashi Shono Kentaro Kamikawa Atsushi Urata Jiro Nasu Haruo Imamura Ikuo Matsushita Tatsuyuki Kakuma Shuji Tada Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones Clinical Endoscopy common bile duct stone cannulation endoscopic retrograde cholangiopancreatography factor |
| title | Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones |
| title_full | Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones |
| title_fullStr | Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones |
| title_full_unstemmed | Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones |
| title_short | Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones |
| title_sort | factors predicting difficult biliary cannulation during endoscopic retrograde cholangiopancreatography for common bile duct stones |
| topic | common bile duct stone cannulation endoscopic retrograde cholangiopancreatography factor |
| url | http://www.e-ce.org/upload/pdf/ce-2021-153.pdf |
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