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01-10-2021 | Cholangitis

Cannulation procedure optimization for patients with duodenal papillary tumors

Authors: Junbo Hong, Honogtao Zhu, Wei Zuo, Liang Zhu, Xiaodong Zhou, Xiaojiang Zhou, Guohua Li, Zhijian Liu, Pi Liu, Hao Zhen, Yong Zhu, Anjiang Wang, Jiuhong Ma, Jianhui Yuan, Xu Shu, Yin Zhu, Nonghua Lu, Youxiang Chen

Published in: Surgical Endoscopy | Issue 10/2021

Abstract

Background

The goal of this study was to compare the efficacy and safety of needle-knife fistulotomy (NKF) to that of conventional cannulation methods (CCMs) when used for primary biliary access in patients with duodenal papillary tumors.

Methods

Consecutive patients who had duodenal papillary tumors and who underwent endoscopic retrograde cholangiopancreatography (ERCP) were retrospectively enrolled. Successful cannulation rates, cannulation and procedure times, and the prevalence of adverse events were compared between the NKF and CCM groups.

Results

A total of 404 patients (NKF, n = 124; CCM, n = 280) with duodenal papillary tumors were included. The primary and overall cannulation rates were 92.1% (372/404) and 96.0% (388/404), respectively. Compared to CCMs, NKF was associated with a significantly higher successful cannulation rate (99.2% versus 88.9%, P < 0.001) and significantly lower cannulation times (2.1 ± 2.0 min versus 4.7 ± 5.2 min), procedure times (8.8 ± 3.8 min versus 12.9 ± 7.6 min), and unintentional pancreatic duct cannulation rates (1.6% versus 20%), with P < 0.001 for all. Overall adverse events occurred less frequently in the NKF group (3.2% versus 10.7%, P = 0.011). Of these adverse events, post-ERCP pancreatitis (PEP) was significantly lower in the NKF group than in the CCM group (1.6% versus 6.8%, P = 0.03). Bleeding and cholangitis rarely occurred with either cannulation method (0.8% versus 2.1%, P = 0.681, and 0.8% versus 1.7%, P = 0.671, respectively).

Conclusion

NKF is a more effective and safer procedure than CCMs for patients with duodenal papillary tumors.

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Title: Cannulation procedure optimization for patients with duodenal papillary tumors
Authors: Junbo Hong
Honogtao Zhu
Wei Zuo
Liang Zhu
Xiaodong Zhou
Xiaojiang Zhou
Guohua Li
Zhijian Liu
Pi Liu
Hao Zhen
Yong Zhu
Anjiang Wang
Jiuhong Ma
Jianhui Yuan
Xu Shu
Yin Zhu
Nonghua Lu
Youxiang Chen
Publication date: 01-10-2021
Publisher: Springer US
Keywords: Cholangitis
Endoscopic Retrograde Cholangiopancreatography
Published in: Surgical Endoscopy / Issue 10/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-08076-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Cannulation procedure optimization for patients with duodenal papillary tumors

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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