Precut sphincterotomy: efficacy for ductal access and the risk of adverse events.
Gastrointest Endosc
; 81(4): 924-31, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25440676
ABSTRACT
BACKGROUND:
Successful ductal access is achieved in 90% of patients who undergo ERCP. Precut sphincterotomy has been advocated when routine cannulation is not possible.OBJECTIVE:
To evaluate the efficacy of precut sphincterotomy for ductal access and the risk of adverse events including post-ERCP pancreatitis (PEP) associated with it.DESIGN:
Retrospective analysis of ERCP procedures performed from 2002 to 2011.SETTING:
Referral center. PATIENTS A total of 10,202 consecutive patients who underwent native cannulation ERCP. MAIN OUTCOME MEASUREMENTS Efficacy for ductal access and risk of adverse events including PEP.RESULTS:
A total of 706 patients required precut sphincterotomy, 614 of whom (86.9%) had successful biliary cannulation. PEP was diagnosed in 58 (8.2â%), perforation in 6 (0.8%), and bleeding in 49 (6.9%) patients. On multivariate analysis, unsuccessful precut sphincterotomy (odds ratio [OR] 2.59; 95% confidence interval [CI], 1.53-4.40; P < .001) and female sex (OR 1.95; 95% CI, 1.23-3.07; P = .004) were associated with increased risk of the development of adverse events. Female sex (OR 2.42; 95% CI, 1.29-4.55; P = .006) and sphincter of Oddi dysfunction (OR 2.77; 95% CI, 1.16-6.60; P = .02) were associated with an increased risk of PEP.LIMITATIONS:
Retrospective study.CONCLUSIONS:
Precut sphincterotomy is effective in achieving ductal access when standard cannulation techniques fail. A successful precut sphincterotomy is not associated with an increased risk of adverse events.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pancreatite
/
Cateterismo
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Colangiopancreatografia Retrógrada Endoscópica
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Esfinterotomia Endoscópica
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Doenças do Ducto Colédoco
/
Hemorragia
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos