Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy
Background and Study Aims Among cases of difficult biliary cannulation, alternatives include use of a pancreatic duct stent (PDS) or guidewire (PDW) to facilitate access. We compared the effectiveness of a PDS versus a PDW to facilitate common bile duct (CBD) cannulation. Patients and Methods We con...
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| مؤلفون آخرون: | , , , , , , |
| التنسيق: | article |
| منشور في: |
2012
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/4311 http://dx.doi.org/10.1007/s10620-012-2269-2 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-012-2269-2 |
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| _version_ | 1864513463199465472 |
|---|---|
| author | Azar, Riad R. |
| author2 | Coté, Gregory A. Mullady, Daniel K. Jonnalagadda, Sreenivasa S. Keswani, Rajesh N. Wani, Sachin B. Hovis, Christine E. Ammar, Tarek |
| author2_role | author author author author author author author |
| author_facet | Azar, Riad R. Coté, Gregory A. Mullady, Daniel K. Jonnalagadda, Sreenivasa S. Keswani, Rajesh N. Wani, Sachin B. Hovis, Christine E. Ammar, Tarek |
| author_role | author |
| dc.creator.none.fl_str_mv | Azar, Riad R. Coté, Gregory A. Mullady, Daniel K. Jonnalagadda, Sreenivasa S. Keswani, Rajesh N. Wani, Sachin B. Hovis, Christine E. Ammar, Tarek |
| dc.date.none.fl_str_mv | 2012 2016-09-19T11:30:50Z 2016-09-19T11:30:50Z 2016-09-19 |
| dc.identifier.none.fl_str_mv | 0163-2116 http://hdl.handle.net/10725/4311 http://dx.doi.org/10.1007/s10620-012-2269-2 Coté, G. A., Mullady, D. K., Jonnalagadda, S. S., Keswani, R. N., Wani, S. B., Hovis, C. E., ... & Azar, R. R. (2012). Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy: a randomized clinical trial. Digestive diseases and sciences, 57(12), 3271-3278. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-012-2269-2 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Digestive Diseases and Sciences |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy a randomized clinical trial |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background and Study Aims Among cases of difficult biliary cannulation, alternatives include use of a pancreatic duct stent (PDS) or guidewire (PDW) to facilitate access. We compared the effectiveness of a PDS versus a PDW to facilitate common bile duct (CBD) cannulation. Patients and Methods We conducted a randomized, crossover trial at two endoscopy referral centers, limited to patients undergoing ERCP without a history of biliary sphincterotomy. After meeting predefined criteria for difficult cannulation, patients were randomized to using a PDS or PDW to facilitate CBD cannulation. Outcomes included cannulation rate within 6 min, overall cannulation rate, frequency of precut, and complication rates. Results Among 442 eligible patients, 87 (19.7 %) met criteria for difficult cannulation. Forty two were randomized to PDW, 54 to PDS (including 9 PDW patients crossed over to PDS). The rate of CBD cannulation within 6 min was similar in the PDW (38.1 %) and PDS (51.9 %) groups (p = 0.18). In a secondary analysis limited to patients who successfully underwent PDW or PDS deployment, the rate was also comparable (PDW 59.3 %, PDS 65.1 %; p = 0.62). The overall frequency of CBD cannulation was 66.7 % in PDW and 90.7 % in PDS patients. Precut was required in 9.5 % of PDW and 25.9 % of PDS patients. Complication rates were similar, with 4 (4.6 %) patients having post-ERCP pancreatitis and 1 (1.1 %) having post-ERCP pain without confirmation of pancreatitis. Conclusions Use of a PDS or PDW facilitates CBD cannulation while maintaining a low complication rate and reducing the need for precut sphincterotomy in the majority of cases. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_546187c516277bd4e5d71cd697c73126 |
| identifier_str_mv | 0163-2116 Coté, G. A., Mullady, D. K., Jonnalagadda, S. S., Keswani, R. N., Wani, S. B., Hovis, C. E., ... & Azar, R. R. (2012). Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy: a randomized clinical trial. Digestive diseases and sciences, 57(12), 3271-3278. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4311 |
| publishDate | 2012 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomya randomized clinical trialAzar, Riad R.Coté, Gregory A.Mullady, Daniel K.Jonnalagadda, Sreenivasa S.Keswani, Rajesh N.Wani, Sachin B.Hovis, Christine E.Ammar, TarekBackground and Study Aims Among cases of difficult biliary cannulation, alternatives include use of a pancreatic duct stent (PDS) or guidewire (PDW) to facilitate access. We compared the effectiveness of a PDS versus a PDW to facilitate common bile duct (CBD) cannulation. Patients and Methods We conducted a randomized, crossover trial at two endoscopy referral centers, limited to patients undergoing ERCP without a history of biliary sphincterotomy. After meeting predefined criteria for difficult cannulation, patients were randomized to using a PDS or PDW to facilitate CBD cannulation. Outcomes included cannulation rate within 6 min, overall cannulation rate, frequency of precut, and complication rates. Results Among 442 eligible patients, 87 (19.7 %) met criteria for difficult cannulation. Forty two were randomized to PDW, 54 to PDS (including 9 PDW patients crossed over to PDS). The rate of CBD cannulation within 6 min was similar in the PDW (38.1 %) and PDS (51.9 %) groups (p = 0.18). In a secondary analysis limited to patients who successfully underwent PDW or PDS deployment, the rate was also comparable (PDW 59.3 %, PDS 65.1 %; p = 0.62). The overall frequency of CBD cannulation was 66.7 % in PDW and 90.7 % in PDS patients. Precut was required in 9.5 % of PDW and 25.9 % of PDS patients. Complication rates were similar, with 4 (4.6 %) patients having post-ERCP pancreatitis and 1 (1.1 %) having post-ERCP pain without confirmation of pancreatitis. Conclusions Use of a PDS or PDW facilitates CBD cannulation while maintaining a low complication rate and reducing the need for precut sphincterotomy in the majority of cases.PublishedN/A2016-09-19T11:30:50Z2016-09-19T11:30:50Z20122016-09-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0163-2116http://hdl.handle.net/10725/4311http://dx.doi.org/10.1007/s10620-012-2269-2Coté, G. A., Mullady, D. K., Jonnalagadda, S. S., Keswani, R. N., Wani, S. B., Hovis, C. E., ... & Azar, R. R. (2012). Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy: a randomized clinical trial. Digestive diseases and sciences, 57(12), 3271-3278.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://link.springer.com/article/10.1007/s10620-012-2269-2enDigestive Diseases and Sciencesinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/43112021-03-19T10:00:50Z |
| spellingShingle | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy Azar, Riad R. |
| status_str | publishedVersion |
| title | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| title_full | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| title_fullStr | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| title_full_unstemmed | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| title_short | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| title_sort | Use of a pancreatic duct stent or guidewire facilitates bile duct access with low rates of precut sphincterotomy |
| url | http://hdl.handle.net/10725/4311 http://dx.doi.org/10.1007/s10620-012-2269-2 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-012-2269-2 |