Application value of needle-knife accurate fistulotomy for difficult biliary cannulation during endoscopic retrograde cholangiopancreatography
10.3760/cma.j.cn115610-20250527-00223
- VernacularTitle:针状刀乳头精准开窗术在内镜逆行胰胆管造影术困难胆管插管中的应用价值
- Author:
Yijun SHU
1
;
Hao WENG
1
;
Mingzhe WENG
1
;
Wenjie ZHANG
1
;
Mingning ZHAO
1
;
Jun GU
1
;
Xuefeng WANG
1
Author Information
1. 上海交通大学医学院附属新华医院普通外科 上海市胆道疾病研究所，上海 200092
- Publication Type:Journal Article
- Keywords:
Biliary tract diseases;
Pancreatic diseases;
Endoscopic retrograde cholangio-pancreatography;
Difficult cannulation;
Needle-knife;
Fistulotomy
- From:
Chinese Journal of Digestive Surgery
2025;24(7):905-911
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of needle-knife accurate fistulo-tomy (NKAF) for difficult biliary cannulation during endoscopic retrograde cholangiopancreato-graphy (ERCP).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 137 patients with difficult biliary cannulation during ERCP at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2021 and December 2022 were collected. There were 51 males and 86 females, aged (69±13)years. All 137 patients received NKAF for cannulation during ERCP. Observation indicators: (1) surgical situations; (2) complications. Measurement data with normal distribution were represented as Mean± SD. Count data were repre-sented as absolute numbers. Results:(1) Surgical situations. Of 137 patients, 136 cases had succe-ssful cannulation, 1 case had failed cannulation with NKAF following unsuccessful double-guidewire technique. In the 136 successful cases, the endoscope was straightened in 42 cases, left in a long position in 37 cases, and maintained in the standard position in 57 cases. The cannulation time was (90±8)s. (2) Complications. The serum amylase at postoperative 6 hours in the 136 successful cases was (163±23)U/L. No patient developed post-ERCP pancreatitis. Of the 136 patients with successful cannulation, one case experienced post-sphincterotomy bleeding, which was observed oozing from the papillary orifice on emergency gastroscopy. The patient was successfully controlled with endoscopic clips.Conclusion:NKAF is safe and effective for difficult biliary cannulation during ERCP.
