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Difficult cannulati...
Difficult cannulation as defined by a prospective study of the Scandinavian Association for Digestive Endoscopy (SADE) in 907 ERCPs
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Halttunen, Jorma (författare)
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Meisner, Soren (författare)
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Aabakken, Lars (författare)
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- Arnelo, Urban (författare)
- Karolinska Institutet
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Gronroos, Juha (författare)
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Hauge, Truls (författare)
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Kleveland, Per M. (författare)
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Schmidt, Palle Nordblad (författare)
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Saarela, Arto (författare)
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Swahn, Fredrik (författare)
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- Toth, Ervin (författare)
- Lund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups
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Mustonen, Harri (författare)
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- Lohr, J. -Matthias (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2014-03-14
- 2014
- Engelska.
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 49:6, s. 752-758
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.3...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background. The definition of a "difficult" cannulation varies considerably in reports of endoscopic retrograde cholangiopancreatography (ERCP). Aims. To define a difficult cannulation, which translates into higher risk of post-ERCP pancreatitis. Patients and methods. Prospective consecutive recording of 907 cannulations in Scandinavian centers done by experienced endoscopists. Inclusion: indication for biliary access in patients with intact papilla. Exclusion: acute non-biliary and chronic pancreatitis at time of procedure. Results. The primary cannulation succeeded in 74.9%, with median values for time 0.88 min (53 s), with two attempts and with zero pancreatic passages or injections. The overall cannulation success was 97.4% and post-ERCP pancreatitis (PEP) rate was 5.3%. The median time for all successful cannulations was 1.55 min (range 0.02-94.2). If the primary cannulation succeeded, the pancreatitis rate was 2.8%; after secondary methods, it rose to 11.5%. Procedures lasting less than 5 min had a PEP rate of 2.6% versus 11.8% in those lasting longer. With one attempt, the PEP rate was 0.6%, with two 3.1%, with three to four 6.1%, and with five and more 11.9%. With one accidental pancreatic guide-wire passage, the risk of the PEP was 3.7%, and with two passages, it was 13.1%. Conclusions. If the increasing rate of PEP is taken as defining factor, the wire-guided cannulation of a native papilla can be considered difficult after 5 min, five attempts, and two pancreatic guide-wire passages when any of those limits is exceeded.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- cannulation
- ERCP
- needle knife
- sphincterotomy
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Halttunen, Jorma
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Meisner, Soren
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Aabakken, Lars
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Arnelo, Urban
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Gronroos, Juha
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Hauge, Truls
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visa fler...
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Kleveland, Per M ...
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Schmidt, Palle N ...
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Saarela, Arto
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Swahn, Fredrik
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Toth, Ervin
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Mustonen, Harri
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Lohr, J. -Matthi ...
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visa färre...
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Lunds universitet
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Karolinska Institutet