Risk factors of selective biliary cannulation in endoscopic retrograde cholangiopancreatography for choledocholithiasis and the value of assistant cannulation methods

• DOI: 10.3760/cma.j.issn.1007-5232.2017.04.010
• Publication Date: 2017-04-20
• Authors: Wang Run-zhi; Zhen Han; Guozheng Zhang; Chiyi He; Heming Yuan; Yuliang Jia; Qiang Yao
• Keywords: Major duodenal papilla; Univariate analysis

Objective To investigate the risk factors of standard selectivity biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP) for patints with choledocholithiasis, and effect safety assistant methods.

Methods The clinical data were retrospectively analyzed 372 patients, who received ERCP choledocholithiasis Yijishan Hospital Wannan Medical College from January 2014 to December 2014. The assessed by univariate multivariate logistic regression analysis. success rate incidence post-ERCP pancreatitis (PEP) compared double-guide wire technique (DGT) precut sphincterotomy (PS), which used when failed.

Results The analysis showed that floppy long duodenal papilla(P=0.000), angulated common bile duct(P=0.013) related failure cannulation.Multivariate papilla (P=0.000, OR=0.131, 95%CI: 0.056-0.307), duct (P=0.003, OR=0.378, 0.197-0.726) independent cannulation. was 83.3% (310/372), 62 cases undergone DGT or PS after failure, total 99.7% (371/372). There 29 suffered PEP 371 successful cannulation, including 18 (5.8%, 18/310) 8 (16.3%, 8/49) DGT, 3 (25.0%, 3/12) PS. (χ2=5.532, P=0.019) (χ2=6.994, P=0.008) significantly higher than but there no statistical difference on between (χ2=0.079, P=0.778).

Conclusion Floppy could easily induce patients choledocholithiasis. are effective methods fails.

Key words: Choledocholithiasis; Cholangiopancreatography, retrograde; Intubation; Risk factors; Safety