PMID- 34362708
OWN - NLM
STAT- MEDLINE
DCOM- 20220505
LR  - 20220505
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 54
IP  - 4
DP  - 2022 Apr
TI  - Difficult biliary cannulation in patients with distal malignant biliary 
      obstruction: An underestimated problem?
PG  - 529-536
LID - S1590-8658(21)00378-9 [pii]
LID - 10.1016/j.dld.2021.07.010 [doi]
AB  - BACKGROUND: Failed biliary cannulation still poses a major challenge in patients 
      undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP). To date, there 
      is a lack of data on rates of Difficult Biliary Cannulation (DBC) in patients 
      with distal malignant biliary obstruction (DMBO). MATERIALS: This was a 
      retrospective study (09/2015 to 02/2019) of consecutive patients with DMBO that 
      underwent ERCP in four Italian centers. The primary outcome was to evaluate the 
      rate of DBC. Secondary outcomes were: cannulation failure, rate of adverse events 
      (AEs), the predictive factors for DBC as well as for AEs. RESULTS: A total of 622 
      patients with DMBO, were included in the study, with 351(56,4%) matching the 
      definition of DBC. One-hundred and two ERCP-related AEs occurred in 97 of 622 
      patients (15,6%). Subjects with DBC showed a higher risk for AEs (p = 0.02). The 
      lack of pancreatitis prophylaxis (p = 0.03), diagnosis of cholangiocarcinoma 
      (p = 0.02), the use of papillotomy (OR=1.98; 95%CI = 1.14-3.45) and the 
      combination of two or more techniques for cannulation (OR = 2.88; 
      95%CI = 1.04-7.97) were associated with the occurrence of AEs. CONCLUSIONS: 
      According to the results of this study, patients with DMBO carries a higher rate 
      of DBC thus requiring alternative techniques for biliary drainage. Furthermore, 
      DBC carries a high risk for AEs. Further prospective multicentric studies are 
      needed to confirm these data in this specific subgroup of patients.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Fugazza, Alessandro
AU  - Fugazza A
AD  - Digestive Endoscopy Unit, Departement of Gastroenterology, Humanitas Research 
      Hospital-IRCCS, Rozzano, Italy. Electronic address: 
      alessandro.fugazza@humanitas.it.
FAU - Troncone, Edoardo
AU  - Troncone E
AD  - Department of Systems Medicine, University of Rome ;;Tor Vergata'', Rome 00133, 
      Italy.
FAU - Amato, Arnaldo
AU  - Amato A
AD  - Division of Digestive Endoscopy and Gastroenterology, Valduce Hospital, Como, 
      Italy.
FAU - Tarantino, Ilaria
AU  - Tarantino I
AD  - Digestive Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT, Palermo, Italy.
FAU - Iannone, Andrea
AU  - Iannone A
AD  - Section of Gastroenterology, Department of Emergency and Organ Transplantation, 
      University of Bari, Bari, Italy.
FAU - Donato, Giulio
AU  - Donato G
AD  - Azienda Ospedaliero Universitaria "Maggiore della Carita", Novara, Italy.
FAU - D'Amico, Ferdinando
AU  - D'Amico F
AD  - Digestive Endoscopy Unit, Departement of Gastroenterology, Humanitas Research 
      Hospital-IRCCS, Rozzano, Italy.
FAU - Mogavero, Giuseppe
AU  - Mogavero G
AD  - Division of Digestive Endoscopy and Gastroenterology, Valduce Hospital, Como, 
      Italy.
FAU - Amata, Michele
AU  - Amata M
AD  - Digestive Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT, Palermo, Italy.
FAU - Fabbri, Carlo
AU  - Fabbri C
AD  - Gastroenterology and Digestive Endoscopy Unit, Medical Department, Forli-Cesena 
      Hospitals, AUSL Romagna.
FAU - Radaelli, Franco
AU  - Radaelli F
AD  - Division of Digestive Endoscopy and Gastroenterology, Valduce Hospital, Como, 
      Italy.
FAU - Occhipinti, Pietro
AU  - Occhipinti P
AD  - Azienda Ospedaliero Universitaria "Maggiore della Carita", Novara, Italy.
FAU - Repici, Alessandro
AU  - Repici A
AD  - Digestive Endoscopy Unit, Departement of Gastroenterology, Humanitas Research 
      Hospital-IRCCS, Rozzano, Italy; Department of Biomedical Sciences, Humanitas 
      University, Pieve Emanuele, Milan, Italy.
FAU - Anderloni, Andrea
AU  - Anderloni A
AD  - Digestive Endoscopy Unit, Departement of Gastroenterology, Humanitas Research 
      Hospital-IRCCS, Rozzano, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210804
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
SB  - IM
MH  - *Biliary Tract
MH  - Catheterization/adverse effects/methods
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods
MH  - *Cholestasis/etiology/surgery
MH  - Humans
MH  - Retrospective Studies
MH  - Sphincterotomy, Endoscopic/methods
OTO - NOTNLM
OT  - Difficult biliary cannulation
OT  - ERCP
OT  - Malignant common bile duct strictures
OT  - Rescue therapies
EDAT- 2021/08/08 06:00
MHDA- 2022/05/06 06:00
CRDT- 2021/08/07 05:40
PHST- 2021/04/20 00:00 [received]
PHST- 2021/07/13 00:00 [revised]
PHST- 2021/07/14 00:00 [accepted]
PHST- 2021/08/08 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2021/08/07 05:40 [entrez]
AID - S1590-8658(21)00378-9 [pii]
AID - 10.1016/j.dld.2021.07.010 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2022 Apr;54(4):529-536. doi: 10.1016/j.dld.2021.07.010. Epub 2021 
      Aug 4.