PMID- 35931625
OWN - NLM
STAT- MEDLINE
DCOM- 20221101
LR  - 20221228
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 54
IP  - 11
DP  - 2022 Nov
TI  - Double guide-wire technique versus transpancreatic biliary sphincterotomy for 
      difficult biliary cannulation: Real life experience from a referral center.
PG  - 1548-1553
LID - S1590-8658(22)00594-1 [pii]
LID - 10.1016/j.dld.2022.07.011 [doi]
AB  - BACKGROUND: During ERCP for biliary indication, when a difficult bile duct (BD) 
      cannulation occurs, with unintended access to the main pancreatic duct (PD), both 
      double guidewire technique (DGW) and transpancreatic biliary sphincterotomy 
      (TPBS) can be performed. We aimed to compare the technical success and adverse 
      events (AEs) rate of these techniques. METHODS: A retrospective analysis of 
      patients with naive papillae referred to the Pancreas Institute of Verona from 
      January 2016 and July 2021 to undergo ERCP for biliary indications was performed. 
      RESULTS: Overall, 202 patients (53.5% males, mean age 67.2 years) were evaluated 
      (96 DGW, 106 TPBS). Malignant biliary stricture was the most common ERCP 
      indication (78.2%). The rate of success in deep biliary cannulation was 
      significantly higher in the DGW group (94.8%) compared to TPBS (79.2%) at the 
      first attempt (p = 0.001). This result was also confirmed in the subgroup of 
      patients with malignant distal stricture (72/77, 93.5% vs 63/80, 78.8%, 
      p = 0.01). No significant difference in AEs rate, particularly in PEP incidence 
      was found between the two groups. CONCLUSIONS: DGW demonstrated a higher success 
      rate and similar safety profile compared with TPBS in difficult biliary 
      cannulation. Based on this retrospective study, DGW should be preferred over TPBS 
      in case of unintended PD cannulation. Further prospective studies are needed to 
      confirm our results.
CI  - Copyright (c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Pin, Federico
AU  - Pin F
AD  - Diagnostic and interventional Endoscopy of Pancreas, Pancreas Institute, 
      University of Verona, Italy.
FAU - Conti Bellocchi, Maria Cristina
AU  - Conti Bellocchi MC
AD  - Diagnostic and interventional Endoscopy of Pancreas, Pancreas Institute, 
      University of Verona, Italy. Electronic address: 
      mariacristina.contibellocchi@aovr.veneto.it.
FAU - Crino, Stefano Francesco
AU  - Crino SF
AD  - Diagnostic and interventional Endoscopy of Pancreas, Pancreas Institute, 
      University of Verona, Italy.
FAU - Bernardoni, Laura
AU  - Bernardoni L
AD  - Diagnostic and interventional Endoscopy of Pancreas, Pancreas Institute, 
      University of Verona, Italy.
FAU - Facciorusso, Antonio
AU  - Facciorusso A
AD  - Digestive Endoscopy Unit, Department of Medical Sciences, University of Foggia, 
      Foggia, Italy.
FAU - Gabbrielli, Armando
AU  - Gabbrielli A
AD  - Diagnostic and interventional Endoscopy of Pancreas, Pancreas Institute, 
      University of Verona, Italy.
LA  - eng
PT  - Comment
PT  - Journal Article
DEP - 20220802
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
CON - Endoscopy. 2021 Oct;53(10):1011-1019. PMID: 33440441
MH  - Male
MH  - Humans
MH  - Aged
MH  - Female
MH  - *Sphincterotomy, Endoscopic/adverse effects/methods
MH  - Retrospective Studies
MH  - Constriction, Pathologic/etiology
MH  - Treatment Outcome
MH  - *Catheterization/methods
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods
MH  - Referral and Consultation
OTO - NOTNLM
OT  - Difficult biliary cannulation
OT  - Distal stricture
OT  - Double-guidewire technique
OT  - Endoscopic retrograde cholangiopancreatography
OT  - Transpancreatic biliary sphincterotomy
OT  - post-ERCP pancreatitis
EDAT- 2022/08/06 06:00
MHDA- 2022/11/02 06:00
CRDT- 2022/08/05 22:06
PHST- 2022/05/20 00:00 [received]
PHST- 2022/07/19 00:00 [accepted]
PHST- 2022/08/06 06:00 [pubmed]
PHST- 2022/11/02 06:00 [medline]
PHST- 2022/08/05 22:06 [entrez]
AID - S1590-8658(22)00594-1 [pii]
AID - 10.1016/j.dld.2022.07.011 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2022 Nov;54(11):1548-1553. doi: 10.1016/j.dld.2022.07.011. Epub 
      2022 Aug 2.