3D-assisted ERCP enhances cannulation efficiency in malignant biliary obstruction: a prospective two-center study

Area of Science:

• Medical Imaging
• Gastroenterology
• Surgical Technology

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) is standard for malignant biliary obstruction.
• ERCP is challenging in pancreatic cancer patients, often causing prolonged cannulation times.
• Three-dimensional (3D) reconstruction offers potential to improve ERCP outcomes.

Purpose of the Study:

• To evaluate the efficacy of 3D reconstruction-assisted ERCP.
• To compare 3D-assisted ERCP with conventional ERCP in pancreatic cancer patients.
• To assess the impact of 3D assistance on procedure duration, success rates, and safety.

Main Methods:

• Prospective two-center study of 72 patients with pancreatic cancer and obstructive jaundice.
• Intervention group (36 patients) underwent 3D reconstruction-assisted ERCP.
• Control group (36 patients) received conventional ERCP.

Main Results:

• 3D-assisted ERCP significantly reduced cannulation time (13.5 min vs 16 min).
• X-ray exposure time was significantly lower with 3D assistance (34.5s vs 40.5s).
• Technical success (97.2% vs 100%), clinical success (77.8% vs 83.3%), and adverse event rates (19.44% vs 13.89%) showed no significant differences.

Conclusions:

• 3D reconstruction-assisted ERCP is a valuable tool for malignant biliary obstruction.
• The technique enhances safety and efficiency by reducing procedure time and X-ray exposure.
• 3D assistance improves the management of challenging ERCP cases in pancreatic cancer patients.