TY - JOUR
T1 - Impact of introduction of wire-guided cannulation in therapeutic biliary endoscopic retrograde cholangiopancreatography
AU - Nakai, Yousuke
AU - Isayama, Hiroyuki
AU - Tsujino, Takeshi
AU - Sasahira, Naoki
AU - Hirano, Kenji
AU - Kogure, Hirofumi
AU - Sasaki, Takashi
AU - Kawakubo, Kazumichi
AU - Yagioka, Hiroshi
AU - Yashima, Yoko
AU - Mizuno, Suguru
AU - Yamamto, Keisuke
AU - Arizumi, Toshihiko
AU - Togawa, Osamu
AU - Matsubara, Saburo
AU - Yamamoto, Natsuyo
AU - Tada, Minoru
AU - Omata, Masao
AU - Koike, Kazuhiko
PY - 2011/10
Y1 - 2011/10
N2 - Background and Aim: Wire-guided cannulation (WGC) might increase the biliary cannulation rate and decrease the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). We assessed the learning curve for WGC in therapeutic biliary ERCP (study 1) and compared WGC and conventional contrast-assisted cannulation (CC) by a matched case-control study (study 2). Methods: Prospectively collected data of 500 therapeutic biliary ERCP cases (250 consecutive cases of WGC and 250 matched controls of CC) were retrospectively studied. Rate and time of biliary cannulation, total procedure time, PEP, and hyperamylasemia were analyzed. Results: In study 1, biliary cannulation by WGC was successful in 96% of the first 50 cases, with a median time to cannulation of 3min. Rates of hyperamylasemia were within 10% after 100 WGC. In study 2, there were no significant differences in the overall cannulation rate and PEP between WGC and CC, but the total procedure time was shorter in WGC (30 vs 35min, P=0.059). Rates of hyperamylasemia and the change in serum amylase levels was lower (9% vs 14%, P=0.069, and +62.8U/L vs+169.5U/L, P=0.043) in WGC, which was more prominent in experienced endoscopists (9% vs 17%, P=0.025, and +68.9U/L vs+229.3U/L, P=0.014). Conclusions: The introduction of WGC was effective in the first 50 cases and did not increase the rate of PEP in biliary therapeutic ERCP.
AB - Background and Aim: Wire-guided cannulation (WGC) might increase the biliary cannulation rate and decrease the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). We assessed the learning curve for WGC in therapeutic biliary ERCP (study 1) and compared WGC and conventional contrast-assisted cannulation (CC) by a matched case-control study (study 2). Methods: Prospectively collected data of 500 therapeutic biliary ERCP cases (250 consecutive cases of WGC and 250 matched controls of CC) were retrospectively studied. Rate and time of biliary cannulation, total procedure time, PEP, and hyperamylasemia were analyzed. Results: In study 1, biliary cannulation by WGC was successful in 96% of the first 50 cases, with a median time to cannulation of 3min. Rates of hyperamylasemia were within 10% after 100 WGC. In study 2, there were no significant differences in the overall cannulation rate and PEP between WGC and CC, but the total procedure time was shorter in WGC (30 vs 35min, P=0.059). Rates of hyperamylasemia and the change in serum amylase levels was lower (9% vs 14%, P=0.069, and +62.8U/L vs+169.5U/L, P=0.043) in WGC, which was more prominent in experienced endoscopists (9% vs 17%, P=0.025, and +68.9U/L vs+229.3U/L, P=0.014). Conclusions: The introduction of WGC was effective in the first 50 cases and did not increase the rate of PEP in biliary therapeutic ERCP.
KW - Endoscopic retrograde cholangiopancreatography
KW - Learning curve
KW - Post-endoscopic retrograde cholangiopancreatography pancreatitis
KW - Wire-guided cannulation
UR - https://www.scopus.com/pages/publications/80053107079
U2 - 10.1111/j.1440-1746.2011.06788.x
DO - 10.1111/j.1440-1746.2011.06788.x
M3 - 記事
AN - SCOPUS:80053107079
SN - 0815-9319
VL - 26
SP - 1552
EP - 1558
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 10
ER -