PMID- 36124489
OWN - NLM
STAT- MEDLINE
DCOM- 20230126
LR  - 20230422
IS  - 1998-4049 (Electronic)
IS  - 1319-3767 (Print)
IS  - 1319-3767 (Linking)
VI  - 29
IP  - 1
DP  - 2023 Jan-Feb
TI  - Factors and techniques associated with endoscopic retrograde 
      cholangiopancreatography outcomes in patients with periampullary diverticulum: 
      Results from a large tertiary center.
PG  - 12-20
LID - 10.4103/sjg.sjg_311_22 [doi]
AB  - 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.
FAU - Xia, Chuanchao
AU  - Xia C
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai, China.
FAU - Sun, Liqi
AU  - Sun L
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai; Department of Gastroenterology, 72th Group Army Hospital, 
      Huzhou University, Huzhou, Zhejiang Province, China.
FAU - Peng, Lisi
AU  - Peng L
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai, China.
FAU - Cui, Fang
AU  - Cui F
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai; Department of Gastroenterology, 72th Group Army Hospital, 
      Huzhou University, Huzhou, Zhejiang Province, China.
FAU - Jin, Zhendong
AU  - Jin Z
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai, China.
FAU - Huang, Haojie
AU  - Huang H
AD  - Department of Gastroenterology, Changhai Hospital, Second Military Medical 
      University, Shanghai, China.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Saudi J Gastroenterol
JT  - Saudi journal of gastroenterology : official journal of the Saudi 
      Gastroenterology Association
JID - 9516979
SB  - IM
MH  - Humans
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods
MH  - *Ampulla of Vater/surgery
MH  - Treatment Outcome
MH  - Catheterization/adverse effects/methods
MH  - Sphincterotomy, Endoscopic/adverse effects/methods
MH  - *Duodenal Diseases/etiology/surgery
MH  - *Diverticulum/surgery/etiology
MH  - Retrospective Studies
PMC - PMC10117011
OTO - NOTNLM
OT  - Adverse events (AEs)
OT  - clinical success rate
OT  - difficult cannulation
OT  - endoscopic retrograde cholangiopancreatography (ERCP)
OT  - periampullary diverticulum (PAD)
COIS- None
EDAT- 2022/09/21 06:00
MHDA- 2023/01/27 06:00
PMCR- 2022/09/16
CRDT- 2022/09/20 03:23
PHST- 2022/09/21 06:00 [pubmed]
PHST- 2023/01/27 06:00 [medline]
PHST- 2022/09/20 03:23 [entrez]
PHST- 2022/09/16 00:00 [pmc-release]
AID - 356199 [pii]
AID - SJG-29-12 [pii]
AID - 10.4103/sjg.sjg_311_22 [doi]
PST - ppublish
SO  - Saudi J Gastroenterol. 2023 Jan-Feb;29(1):12-20. doi: 10.4103/sjg.sjg_311_22.