The effect of using nitroderm TTS in ERCP on precut, selective cannulation, and bleeding

Area of Science:

• Gastroenterology
• Interventional Endoscopy

Background:

• Obstructive jaundice is a condition requiring endoscopic retrograde cholangiopancreatography (ERCP).
• ERCP procedures carry risks of complications such as pancreatitis, bleeding, and perforation.
• Prophylactic measures are sought to improve ERCP safety and efficacy.

Purpose of the Study:

• To evaluate the efficacy of prophylactic nitroglycerin patches in patients undergoing ERCP.
• To assess the impact of nitroglycerin on procedure-related complications, duration, and outcomes.

Main Methods:

• Retrospective analysis of hospital database records.
• Exclusion of patients under 18, those in poor general condition, or treated emergently.
• Comparison of outcomes between patients who received nitroglycerin patches and those who did not.

Main Results:

• Nitroglycerin use decreased the need for precut cannulation by 2.28 times (p<0.001).
• Perioperative bleeding was reduced by 3.4 times with nitroglycerin (p<0.001).
• Selective cannulation rates increased from 75.1% to 87.3% (p<0.001), with nitroglycerin increasing the odds by 2.21 times (p<0.001).

Conclusions:

• Prophylactic nitroglycerin patches enhance selective cannulation rates during ERCP.
• Nitroglycerin use is associated with reduced precut rates, perioperative bleeding, hospital stay, and procedure time.
• The study demonstrates a significant benefit of nitroglycerin in improving ERCP procedural success and safety.