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Clinical usefulness of double-guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography

Ito, Kei ; Horaguchi, Jun ; Fujita, Naotaka ; Noda, Yutaka ; Kobayashi, Go ; Koshita, Shinsuke ; Kanno, Yoshihide ; Ogawa, Takahisa ; Masu, Kaori ; Hashimoto, Shinichi

Digestive endoscopy, 2014-05, Vol.26 (3), p.442-449 [Periódico revisado por pares]

Australia: Blackwell Publishing Ltd

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Título:
Clinical usefulness of double-guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography
Autor: Ito, Kei ; Horaguchi, Jun ; Fujita, Naotaka ; Noda, Yutaka ; Kobayashi, Go ; Koshita, Shinsuke ; Kanno, Yoshihide ; Ogawa, Takahisa ; Masu, Kaori ; Hashimoto, Shinichi
Assuntos: Adult ; Aged ; Aged, 80 and over ; Ampulla of Vater - physiopathology ; Ampulla of Vater - surgery ; Analysis of Variance ; biliary cannulation ; Catheterization - adverse effects ; Catheterization - instrumentation ; Catheterization - methods ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde - adverse effects ; Cholangiopancreatography, Endoscopic Retrograde - instrumentation ; Cholangiopancreatography, Endoscopic Retrograde - methods ; Cholestasis - diagnosis ; Cholestasis - surgery ; Cohort Studies ; endoscopic retrograde cholangiopancreatography (ERCP) ; Female ; Humans ; Japan ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; pancreatic duct stenting ; Pancreatic Ducts - physiopathology ; Pancreatic Ducts - surgery ; pancreatitis ; Pancreatitis - etiology ; Pancreatitis - prevention & control ; Patient Safety ; Retrospective Studies ; Risk Assessment ; Sphincterotomy, Endoscopic - adverse effects ; Sphincterotomy, Endoscopic - methods ; Statistics, Nonparametric ; Stents ; Treatment Outcome ; wire-guided cannulation
É parte de: Digestive endoscopy, 2014-05, Vol.26 (3), p.442-449
Notas: ark:/67375/WNG-MG62TPNR-S
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ArticleID:DEN12158
ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Background and Aim Although biliary cannulation with pancreatic guidewire placement (P‐GW) is useful for difficult cases in endoscopic retrograde cholangiopancreatography (ERCP), the clinical significance of wire‐guided cannulation with P‐GW (double‐guidewire technique: DGT) has not been clarified. The aim of the present study was to evaluate the usefulness of DGT for difficult biliary cannulation after unsuccessful biliary cannulation using a cannula/sphincterotome under guidance of injected contrast with P‐GW (single‐guidewire technique: SGT). Methods One‐hundred and forty‐six patients with difficult biliary cannulation who underwent SGT were included in this retrospective study. DGT was carried out if SGT was unsuccessful. Pancreatic duct (PD) stenting was attempted to prevent post‐ERCP pancreatitis (PEP) in all patients. The success rate of cannulation and the risk factors for PEP were investigated. Results Biliary cannulation with SGT was achieved in 70%. DGT was carried out in 25 patients with unsuccessful SGT, biliarycannulation being successful in 72%. Of the 13 patients who underwent precut sphincterotomy, biliary cannulation was achieved in 46%. The incidence of PEP in patients who had undergone SGT, DGT, and precut sphincterotomy was 8% (12: mild, 8; moderate, 3; severe, 1), 4% (mild, 1), and 0%, respectively. PD stenting was successfully carried out in 86%. Multivariate analysis revealed unsuccessful PD stenting to be the only risk factor for PEP (OR 8.3, 95% CI 2.3–30). Conclusions DGT may replace SGT or become the salvage procedure in cases of unsuccessful SGT as a result of its high success rate with an acceptable incidence of PEP. Failed pancreatic duct stenting in these techniques was frequently associated with PEP.
Editor: Australia: Blackwell Publishing Ltd
Idioma: Inglês

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Clinical usefulness of double-guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography

Ito, Kei ; Horaguchi, Jun ; Fujita, Naotaka ; Noda, Yutaka ; Kobayashi, Go ; Koshita, Shinsuke ; Kanno, Yoshihide ; Ogawa, Takahisa ; Masu, Kaori ; Hashimoto, Shinichi

Australia: Blackwell Publishing Ltd

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