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Sökning: WFRF:(Karjula H.) > (2019) > Macroscopic appeara...

Macroscopic appearance of the major duodenal papilla influences bile duct cannulation: a prospective multicenter study by the Scandinavian Association for Digestive Endoscopy Study Group for ERCP

Haraldsson, Erik, 1972 (författare)
Karolinska Institutet,Karolinska Institute,Skaraborg Hospital
Kylänpää, L. (författare)
Helsinki University Central Hospital
Grönroos, J. (författare)
Turku University Hospital
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Saarela, A. (författare)
Oulu University Hospital
Toth, Ervin (författare)
Lund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups,Skåne University Hospital
Qvigstad, G. (författare)
St. Olav’s University Hospital
Hult, M. (författare)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
Lindström, O. (författare)
Helsinki University Central Hospital
Laine, S. (författare)
Turku University Hospital
Karjula, H. (författare)
Oulu University Hospital
Hauge, T. (författare)
Oslo university hospital
Sadik, Riadh, 1963 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Sahlgrenska Academy
Arnelo, U. (författare)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
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 (creator_code:org_t)
Elsevier BV, 2019
2019
Engelska.
Ingår i: Gastrointestinal Endoscopy. - : Elsevier BV. - 0016-5107 .- 1097-6779. ; 90:6, s. 957-963
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background and Aims: Certain appearances of the major duodenal papilla have been claimed to make cannulation more difficult during ERCP. This study uses a validated classification of the endoscopic appearance of the major duodenal papilla to determine if certain types of papilla predispose to difficult cannulation. Methods: Patients with a naïve papilla scheduled for ERCP were included. The papilla was classified into 1 of 4 papilla types before cannulation started. Time to successful bile duct cannulation, attempts, and number of pancreatic duct passages were recorded. Difficult cannulation was defined as after 5 minutes, 5 attempts, or 2 pancreatic guidewire passages. Results: A total of 1401 patients were included from 9 different centers in the Nordic countries. The overall frequency of difficult cannulation was 42% (95% confidence interval [CI], 39%-44%). Type 2 small papilla (52%; 95% CI, 45%-59%) and type 3 protruding or pendulous papilla (48%; 95% CI, 42%-53%) were more frequently difficult to cannulate compared with type 1 regular papilla (36%; 95% CI, 33%-40%; both P <.001). If an inexperienced endoscopist started cannulation, the frequency of failed cannulation increased from 1.9% to 6.3% (P <.0001), even though they were replaced by a senior endoscopist after 5 minutes. Conclusions: The endoscopic appearance of the major duodenal papilla influences bile duct cannulation. Small type 2 and protruding or pendulous type 3 papillae are more frequently difficult to cannulate. In addition, cannulation might even fail more frequently if a beginner starts cannulation. These findings should be taken into consideration when performing studies regarding bile duct cannulation and in training future generations of endoscopists. © 2019 American Society for Gastrointestinal Endoscopy

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Oto-rhino-laryngologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Otorhinolaryngology (hsv//eng)

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