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| http://dx.doi.org/10.1016/j.vgie.2020.04.019 | DOI Listing |
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Randomized comparison of precut papillotomy and endosonography guided rendezvous procedure for difficult biliary access in Malignant distal biliary obstruction.
Endoscopy
January 2025
Institute of Gastrosciences, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, India.
Background And Aims: Difficult biliary cannulation (DBC) is a marker for prolonged procedure time and increased adverse event rate (AER) during endoscopic retrograde cholangiopancreatography (ERCP). We previously showed that EUS-guided rendezvous procedure (EUS-RV) had a higher single session success rate than precut papillotomy (PcP) in DBC patients. The present randomized study aims at comparing the technical success and AER between the two approaches.
View Article and Find Full Text PDFPancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation.
World J Gastroenterol
January 2025
Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 33305, Taiwan.
Background: Needle-knife precut papillotomy (NKP) is typically performed freehand. However, it remains unclear whether pancreatic stent (PS) placement can improve the outcomes of NKP.
Aim: To explore whether PS placement improves the success rate of NKP in patients with difficult biliary cannulation.
Can early precut reduce post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with difficult bile duct cannulation?
World J Gastrointest Endosc
September 2024
Department of General Internal Medicine 2, Kawasaki Medical School, Okayama 7008505, Japan.
Article Synopsis
- ERCP is a medical procedure that can have some risks, including a condition called post-ERCP pancreatitis (PEP), which can happen when the procedure is tough to do.
- A study with over 1,500 patients looked at whether doing an early cut (precut technique) helps lower the chances of getting PEP compared to a delayed cut.
- The results showed that early precut patients had a lower risk of PEP (3.5%) compared to those who had a delayed cut (10.5%), and using a pancreatic stent during the delayed cut can help reduce PEP risk even more.
Needle-Knife Fistulotomy Versus Needle-Knife Papillotomy in Difficult Biliary Cannulation: A Systematic Review and Meta-Analysis.
Gastroenterology Res
June 2024
Department of Gastroenterology and Hepatology, University Hospitals, Cleveland, OH, USA.
Article Synopsis
- Endoscopic retrograde cholangiopancreatography (ERCP) is crucial for treating biliary and pancreatic diseases, with needle-knife fistulotomy (NKF) and papillotomy (NKP) being common rescue techniques for challenging cases.
- A meta-analysis of four studies involving 823 patients found no significant difference in success rates for biliary cannulation between NKF (91.7%) and NKP (86.9%), but NKF had a significantly lower rate of adverse events.
- Overall, both NKF and NKP show similar effectiveness, but NKF appears to be safer in terms of complications.
Article Synopsis
- A 74-year-old woman with acute calculous cholangitis underwent ERCP and a pancreatic stent (PS) was placed to prevent post-ERCP pancreatitis after difficult cannulation.
- During the procedure, an endoscopic papillary balloon dilation caused the stent to migrate into the main pancreatic duct (MPD).
- The migrated stent was successfully removed in a follow-up ERCP two days later, highlighting the potential risks of stent migration with early placement during ERCP procedures.
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