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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Single versus two-operator endoscopic biliary cannulation technique: a multicenter matched-case analysis.

Roberto DI Mitri1, Rinaldo Pellicano2, Leonardo H Eusebi3,4

  • 1Unit of Gastroenterology and Digestive Endoscopy, ARNAS Civico Hospital, Palermo, Italy.

Minerva Chirurgica
|April 21, 2017
PubMed
Summary
This summary is machine-generated.

Physician-controlled and assistant-controlled guide-wire biliary cannulation techniques show similar efficacy and safety. Physician control, especially with short wires, trended towards shorter procedure times without significant differences in success or complication rates.

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Biliary Cannulation Techniques

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for biliary and pancreatic duct evaluation and treatment.
  • Biliary cannulation is a critical step in ERCP, with various techniques employed.
  • Comparing physician-controlled and assistant-controlled guide-wire techniques is essential for optimizing ERCP outcomes.

Purpose of the Study:

  • To compare the outcomes of physician-controlled (long and short wire systems) versus assistant-controlled guide-wire biliary cannulation in ERCP.
  • To conduct a literature review on physician-controlled versus assistant-controlled guide-wire biliary cannulation techniques.

Main Methods:

  • A retrospective review of ERCP procedures from three centers (July 2013 - December 2014) involving 240 patients with intact papilla.
  • Patients were matched 1:1 by gender, age, and indication for the procedure.
  • A literature search for relevant articles comparing physician-controlled vs. assistant-controlled guide-wire biliary cannulation was conducted up to December 2016.

Main Results:

  • No statistically significant differences in primary or final cannulation rates were observed between the three groups.
  • Mean cannulation times were shorter in physician-controlled groups, though not statistically significant.
  • No significant differences in total procedure time or complication rates were found; physician-controlled short wire showed a trend towards shorter times.
  • Literature review included three articles, reporting a mean success rate of 92% and complication rate of 7%.

Conclusions:

  • Physician-controlled and assistant-controlled guide-wire biliary cannulation techniques demonstrate comparable efficacy and safety.
  • The choice of technique may be influenced by factors such as desired procedure time, with a trend favoring physician control using short wires.