Minerva chirurgica · 2017
Single versus two-operator endoscopic biliary cannulation technique: a multicenter matched-case analysis.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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DI Mitri Roberto, Pellicano Rinaldo, Eusebi Leonardo H, Mocciaro Filippo, Montalbano Luigi M, Alibrandi Angela, Iabichino Giuseppe, Palamara Maria A, Giunta Marco, Linea Cristina, Arena Monica, Pecoraro Giulia M, Opocher Enrico, Barabino Matteo, Luigiano Carmelo
Аннотация
BACKGROUND: The aim of this study was to compare the outcomes of physician-controlled, using both long and short endoscopic-retrograde-cholangiopancreatography wire systems, and assistant-controlled guide-wire biliary cannulation techniques, and to perform a literature review on this topic.
METHODS: The endoscopic databases of three Endoscopic Centers were reviewed to identify all consecutive patients with an intact papilla who, between July 2013 and December 2014, underwent an endoscopic-retrograde-cholangiopancreatography. A total of 240 patients (80 for each group) were matched 1:1, by gender, age and indications for procedure and were included in the analysis. All articles of physician-controlled vs. assistant-controlled guide-wire biliary cannulation techniques, were extracted up to December 2016, and included in the review.
RESULTS: There were no statistically significant differences in primary and final (using rescue technique) cannulation rate between the three groups. The mean primary cannulation time and overall cannulation time were shorter in the two groups of physician-controlled guide-wire compared to the assistant-controlled guide-wire group, but the difference was not statistically significant. The total procedure time did not differ significantly between the three groups, but the physician-controlled guide-wire using short wire system was associated with a trend toward a shorter time compared to the other two techniques. There were no statistically significant differences in complication rates between the three groups. Three pertinent articles were included in the review. The mean procedure success and complication rates were 92% and 7%, respectively.
CONCLUSIONS: The literature review and our results show that all these techniques have equally efficacy and safety for guide-wire cannulation.
METHODS: The endoscopic databases of three Endoscopic Centers were reviewed to identify all consecutive patients with an intact papilla who, between July 2013 and December 2014, underwent an endoscopic-retrograde-cholangiopancreatography. A total of 240 patients (80 for each group) were matched 1:1, by gender, age and indications for procedure and were included in the analysis. All articles of physician-controlled vs. assistant-controlled guide-wire biliary cannulation techniques, were extracted up to December 2016, and included in the review.
RESULTS: There were no statistically significant differences in primary and final (using rescue technique) cannulation rate between the three groups. The mean primary cannulation time and overall cannulation time were shorter in the two groups of physician-controlled guide-wire compared to the assistant-controlled guide-wire group, but the difference was not statistically significant. The total procedure time did not differ significantly between the three groups, but the physician-controlled guide-wire using short wire system was associated with a trend toward a shorter time compared to the other two techniques. There were no statistically significant differences in complication rates between the three groups. Three pertinent articles were included in the review. The mean procedure success and complication rates were 92% and 7%, respectively.
CONCLUSIONS: The literature review and our results show that all these techniques have equally efficacy and safety for guide-wire cannulation.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCatheterizationCathetersCholangiopancreatography, Endoscopic RetrogradeCommon Bile DuctContrast MediaFemaleGallstonesHumansItalyMagnetic Resonance ImagingMaleMiddle AgedPancreatic DiseasesPancreatic DuctsPatient SelectionProspective StudiesRisk FactorsTime FactorsTreatment Outcome