Endoscopic transpancreatic precut sphincterotomy and double guidewire technique in difficult bile duct cannulation during endo-scopic retrograde cholangiopancreatography
10.3969/j.issn.1007-1989.2017.08.010
- VernacularTitle:经胰管胆胰管隔膜切开术及双导丝术在困难性插管ERCP中的应用及安全性分析
- Author:
Xiong SUN
;
Lei GONG
;
Xiaobin PENG
;
Xuejun TANG
;
Xiaoyun WANG
;
Chunxiao TAN
- Keywords:
endoscopic retrograde cholangiopancreatography;
transpancreatic precut sphincterotomy;
double guide wire technique;
single guide wire technique
- From:
China Journal of Endoscopy
2017;23(8):47-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the applicability and security of transpancreatic precut sphincterotomy vs double guidewire technique for cannulation in difficult bile duct cannulation in endoscopic retrograde eholangiopancreatography (ERCP). Methods Retrospective analysis of 158 cases difficult bile duct cannulation in ERCP from January 2012 to January 2014, according to the intubation tube method, we divided all the cases into 3 groups, transpancreatic precut sphincterotomy group (group A); double guide wire technique group (group B); single guide wire technique group (group C). Then compare the intubation success rate and the incidence of complications among the 3 groups. Results 54 of 58 patients in group A intubation successful, the success rate is 93.1%, 50 of 56 patients in group B intubation successful, the success rate is 89.3%, 26 of 44 patients in group C intubation successful, the success rate is 59.1%, there was no significant difference between group A and B(P > 0.05), group A and group C, group B and C have significant difference (P < 0.05). In group A, 4 cases were complicated with acute pancreatitis, hemorrhage in 6 cases, infection in 2 cases, the complication rate is 20.7%; In group B, 5 cases were complicated with postoperative pancreatitis, 4 cases of infection, incidence of complications is 16.1%; 7 patients were complicated with pancreatitis in group C, hemorrhage in 2 cases, infection in 4 cases, complication rates is 29.5%, 3 groups were no perforation occurred.The complication rate of group B is lower than in group A, but no significant difference (P > 0.05), group A and group C, B and C complication rates had significant difference (P < 0.05). Conclusions When selective bile duct intubation is difficulty and guide wire thread into the pancreatic duct, continue to single guide wire have low intubation success rate and higher incidence of complications,transpancreatic precut sphincterotomy and double guide wire technique can effectively improve the success rate of intubation, and complication rates are relatively low, no significant difference between the two.
