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DOI: 10.1055/s-0041-1724290
Predictors of Precut Techniques Requirement During ERCP Cannulation
Aims To determine the predictive factors of precut access papillotomy techniques requirement during ERCP cannulation.
Methods Analysis of a multicenter prospective endoscopy database (2009-2017). Patients with naive papilla undergone first ERCP, performed by expert endoscopists, were included. There were analyzed ERCP indications, ampulla and duodenum anatomical features, cannulation techniques and duodenoscope positioning to accomplish ERCP.
Results Of 1109 analyzed patients, age: 71,47 ±0,48y; 51.8 % women, 270 (24,3 %) required precut techniques: Needle-Knife: 142 (52,5 %), transpancreatic: 93 (34 %) and 35 (13 %), both them. Overall ERCP cannulation and complication rates: 95 % and 6.7 %, respectively. There were no differences in age, gender, general status and papillary orifice features between standard and precut ERCP cannulation group. Conversely, into precut group, ERCP indicated for malignant disease (35.9 vs. 21.2 %, p =0.001), bilirubin >3mg (27.5 vs. 22.2 %, p =0.048), non-peridiverticular papilla (25.9 vs 18.5 %, p = 0.02), presence of >1 transverse papillary fold (31.5 vs. 21.4 %, p =0.001) and the accomplishment of ERCP in a duodenoscope long position (44.9 vs. 21.5, p =0.001) were more frequent. In a multivariate analysis, ERCP indicated for malignant disease (OR: 1.98; 95 %CI: 1.43 -2.73), presence of >1 transverse fold (OR: 1.53; 95 %CI: 1.12 -2.08) and the accomplishment of ERCP in a duodenoscope long position (OR: 2.69; 95 %CI: 1.85 -3.93) were predictors of precut techniques requirement during ERCP cannulation.
Conclusions ERCP indicated for malignant disease, the presence of >1 transverse papillary fold and the accomplishment of ERCP in a duodenoscope long position are predictors of precut techniques requirement. In these cases, ERCP should be performed or at least supervised by expert endoscopists.
Citation: Zaragoza N, Alburquerque M, Miguel I et al. OP30 PREDICTORS OF PRECUT TECHNIQUES REQUIREMENT DURING ERCP CANNULATION. Endoscopy 2021; 53: S15.
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Publication History
Article published online:
19 March 2021
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