ERCP is more challenging in cases of acute biliary pancreatitis than in acute cholangitis - Analysis of the Hungarian ERCP registry data

Endoscopic retrograde cholangiopancreatography (ERCP) is an important therapeutic modality in acute biliary pancreatitis (ABP) cases with cholangitis or ongoing common bile duct obstruction. Theoretically, inflammation of the surrounding tissues would result in a more difficult procedure. No previou...

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Bibliographic Details
Main Authors: Pécsi Dániel
Gódi Szilárd
Hegyi Péter
Hanák Lilla
Szentesi Andrea Ildikó
Altorjay István
Bakucz Tamás
Czakó László
Kovács György
Orbán-Szilágyi Ákos
Pakodi Ferenc
Patai Árpád
Szepes Zoltán
Gyökeres Tibor
Fejes Roland
Dubravcsik Zsolt
Vincze Áron
Format: Article
Published: 2021
Series:PANCREATOLOGY 21 No. 1
doi:10.1016/j.pan.2020.11.025

mtmt:31782996
Online Access:http://publicatio.bibl.u-szeged.hu/21981
Description
Summary:Endoscopic retrograde cholangiopancreatography (ERCP) is an important therapeutic modality in acute biliary pancreatitis (ABP) cases with cholangitis or ongoing common bile duct obstruction. Theoretically, inflammation of the surrounding tissues would result in a more difficult procedure. No previous studies examined this hypothesis.ABP and acute cholangitis (AC) without ABP cases were compared to assess difficulty of ERCP.The rate of successful biliary access, advanced cannulation method, adverse events, cannulation and fluoroscopy time were compared in 240 ABP cases and 250 AC cases without ABP. Previous papillotomy, altered gastroduodenal anatomy, and cases with biliary stricture were excluded.Significantly more pancreatic guidewire manipulation (adjusted odds ratio (aOR) 1.921 [1.241-2.974]) and prophylactic pancreatic stent use (aOR 4.687 [2.415-9.098]) were seen in the ABP than in AC group. Average cannulation time in the ABP patients (248 vs. 185 s; p = 0.043) were longer than in AC cases. No difference was found between biliary cannulation and adverse events rates.ERCP in ABP cases seem to be more challenging than in AC. Difficult biliary access is more frequent in the ABP cases which warrants the involvement of an experienced endoscopist.
Physical Description:59-63
ISSN:1424-3903