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Efficacy and safety of transpancreatic sphincterotomy in endoscopic retrograde cholangiopancreatography: a retrospective cohort study

Το τεκμήριο παρέχεται από τον φορέα :
Ελληνική Γαστροεντερολογική Εταιρία   

Αποθετήριο :
Annals of Gastroenterology   

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Efficacy and safety of transpancreatic sphincterotomy in endoscopic retrograde cholangiopancreatography: a retrospective cohort study (EN)
Bektsis, Tryfon
Koffas, Apostolos
Pateras, Konstantinos
Kateri, Christina
Kapsoritakis, Andreas
Papaefthymiou, Apostolis
Potamianos, Spyros
Manolakis, Anastasios
Chougias, Dimitrios
Florou, Theodosia
Fytsilis, Fotios
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2022-11-18
Background Difficult cannulation represents a common obstacle during endoscopic retrograde cholangiopancreatography (ERCP). We assessed the efficacy and adverse events of transpancreatic sphincterotomy (TPS), and investigated potential associated confounders. Methods All patients referred to our department for ERCP during 2015-2020 were eligible if they had intact papilla and visceral anatomy. In addition to standard measures, TPS was combined with pancreatic stent placement. Apart from demographics, we retrieved data related to the indication, periampullary anatomy, necessity for TPS or fistulotomy, their outcomes and complications. Chi-square test was employed to investigate associations between TPS and independent variables. When significance was observed, the respective variables were inserted into a regression model. Results A total of 1082 individual patients were eligible, with an equal female: male ratio and a mean age of 72.7±15.82 years. Seventy-three patients (6.7%) underwent TPS, with a 95.9% successful cannulation rate. Papilla morphology or regional diverticulum did not affect the decision to perform TPS, though it was significantly associated with malignant common bile duct (CBD) obstruction as the ERCP indication (P=0.001). Considering adverse events, TPS did not increase the incidence of post-ERCP pancreatitis (PEP), thoughit affected bleeding (P=0.005). Regression analysis revealed a protective role of TPS againstPEP (risk ratio [RR] 0.015, 95% confidence interval [CI] 0.23-5.05; P<0.001), while theaforementioned risk of hemorrhage was attributed to previous precut attempts (RR 3.02,95%CI 1.42-6.43; P=0.004). Conclusion TPS combined with pancreatic stenting is an effective and safe modality in difficultcannulation cases and could be the first-choice alternative in malignant CBD obstruction. Keywords Transpancreatic sphincterotomy, endoscopic retrograde cholangiopancreatography, cannulation success Ann Gastroenterol 2022; 35 (6): 648-653 (EN)
Αγγλική γλώσσα
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 35, No 6 (2022); 648 (EN)
Copyright (c) 2022 Annals of Gastroenterology (EN)
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Original Articles



*Η εύρυθμη και αδιάλειπτη λειτουργία των διαδικτυακών διευθύνσεων των συλλογών (ψηφιακό αρχείο, καρτέλα τεκμηρίου στο αποθετήριο) είναι αποκλειστική ευθύνη των αντίστοιχων Φορέων περιεχομένου.