Risk factors for post-ERCP pancreatitis in wire-guided cannulation for therapeutic biliary ERCP

Background Wire-guided cannulation (WGC) was reported to decrease post-ERCP pancreatitis (PEP), but risk factors for PEP in WGC are not fully elucidated. Objective To evaluate the incidence and risk factors of PEP in WGC. Design Single-center retrospective study. Setting Academic center. Patients A...

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Veröffentlicht in:	Gastrointestinal endoscopy 2015, Vol.81 (1), p.119-126
Hauptverfasser:	Nakai, Yousuke, MD, PhD, Isayama, Hiroyuki, MD, PhD, Sasahira, Naoki, MD, PhD, Kogure, Hirofumi, MD, PhD, Sasaki, Takashi, MD, PhD, Yamamoto, Natsuyo, MD, PhD, Saito, Kei, MD, Umefune, Gyotane, MD, Akiyama, Dai, MD, Kawahata, Shuhei, MD, Matsukawa, Miho, MD, Saito, Tomotaka, MD, Hamada, Tsuyoshi, MD, PhD, Takahara, Naminatsu, MD, PhD, Mizuno, Suguru, MD, PhD, Miyabayashi, Koji, MD, PhD, Mohri, Dai, MD, PhD, Hirano, Kenji, MD, PhD, Tada, Minoru, MD, PhD, Koike, Kazuhiko, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Ampulla of Vater - surgery Bile Duct Diseases - surgery Cholangiopancreatography, Endoscopic Retrograde - adverse effects Choledocholithiasis - surgery Cholestasis - surgery Common Bile Duct - surgery Constriction, Pathologic - surgery Female Gastroenterology and Hepatology Humans Male Middle Aged Multivariate Analysis Pancreatic Ducts - surgery Pancreatic Neoplasms - complications Pancreatic Neoplasms - surgery Pancreatitis - epidemiology Pancreatitis - etiology Retrospective Studies Risk Factors Sphincterotomy, Endoscopic - adverse effects
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Zusammenfassung:	Background Wire-guided cannulation (WGC) was reported to decrease post-ERCP pancreatitis (PEP), but risk factors for PEP in WGC are not fully elucidated. Objective To evaluate the incidence and risk factors of PEP in WGC. Design Single-center retrospective study. Setting Academic center. Patients A total of 800 consecutive patients with a native papilla. Interventions Biliary therapeutic ERCP by using WGC. Main Outcome Measurements The rate of PEP and its risk factors. Results Biliary cannulation was successful by using WGC alone in 70.5%, and the final cannulation rate was 96.1%. Unintentional guidewire insertion and contrast material injection into the pancreatic duct (PD) during cannulation occurred in 55.3% and 21.8%, respectively. The incidence of PEP was 9.5% (mild 5.6%, moderate 2.9%, severe 1.0%). Multivariate analysis revealed a common bile duct (CBD) diameter of
ISSN:	0016-5107 1097-6779
DOI:	10.1016/j.gie.2014.06.005