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- Title
Factors and techniques associated with endoscopic retrograde cholangiopancreatography outcomes in patients with periampullary diverticulum: Results from a large tertiary center.
- Authors
Xia, Chuanchao; Sun, Liqi; Peng, Lisi; Cui, Fang; Jin, Zhendong; Huang, Haojie
- Abstract
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for patients with periampullary diverticulum (PAD) remains a challenge. This study aims to investigate the factors and techniques related to successful and safe ERCP in patients with PAD. Methods: We enrolled patients who underwent ERCP in a large tertiary center. The difficult cannulation rate, technical success rate, clinical success rate, and adverse events (AEs) rate were compared between patients with or without PAD. Three independent logistic regression models were established to identify factors and techniques associated with difficult cannulation, clinical success, and AEs. Results: Five thousand five hundred and ninety patients were included, of which 705 (12.6%) were diagnosed with PAD. Patients with PAD had a significantly higher difficult cannulation rate compared with patients without PAD (10.6% vs 8.0%, P < 0.0001), but the rates of technical success (clinical success (95.2% vs 95.2%, P = 0.951), and AEs (16.5% vs 14.4%, P = 0.156) were similar. Type I PAD (odds ratio [OR] = 2.114, 95% confidence interval [CI]:1.05-5.25) and ERCP indication for pancreatic diseases (OR = 1.196, 95%CI: 1.053-1.261) were independently associated with difficult cannulation. Small endoscopic sphincterotomy (EST) with balloon dilatation (OR = 1.581, 95%CI: 1.044-2.393) was independently associated with clinical success. Somatostatin injection showed no preventive effect on post-ERCP pancreatitis (OR = 1.144, 95%CI: 1.044-1.254). Moreover, the auxiliary cannulation techniques were safe for PAD patients. Conclusions: PAD did not affect ERCP outcomes. However, the choice of techniques and AE prophylactic measures should be more specific, especially for patients with type I PAD.
- Subjects
CONFIDENCE intervals; ENDOSCOPIC retrograde cholangiopancreatography; TERTIARY care; TREATMENT effectiveness; DIVERTICULUM; DESCRIPTIVE statistics; SOMATOSTATIN; RESEARCH funding; LOGISTIC regression analysis; ODDS ratio; CATHETERIZATION; PANCREATITIS; SPHINCTERECTOMY; DISEASE risk factors; EVALUATION
- Publication
Saudi Journal of Gastroenterology, 2023, Vol 29, Issue 1, p12
- ISSN
1319-3767
- Publication type
Article
- DOI
10.4103/sjg.sjg_311_22