Observational studyBMC gastroenterology2020
Duodenal major papilla morphology can affect biliary cannulation and complications during ERCP, an observational study.
Observational study in BMC gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Morphology of the papilla can predict procedural safety and efficacy of ERCP-a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- A Randomized Controlled Trial of Patient Positioning During Endoscopic Retrograde Cholangiopancreatography (ERCP) Procedures: A Comparison Between Semi-Prone- and Prone-Positioned Patients.Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and AssociatesTrial
- Video-Based Analysis of Risk Factors for Post-ERCP Pancreatitis in Pancreatic Guidewire-Assisted Biliary Cannulation.Digestive diseases and sciences · 2026Article
- Post-endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis: a stratified assessment for evaluation of risk approach.iGIE : innovation, investigation and insights · 2026Article
- The Effect of Intravenous Lidocaine on Duodenal Peristalsis and Sedation Quality During Endoscopic Retrograde Cholangiopancreatography: A Randomized Controlled Trial.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Article
- Transpapillary pancreatic duct stenting as a salvage therapy for refractory pancreatic fistula after distal pancreatectomy: a case series supporting the role of duodenal papilla obstruction.Surgical endoscopy · 2026Article
- Difficult biliary cannulation among patients with compensated liver cirrhosis: predictors and impact on complications.Scientific reports · 2026Article
- Safety and efficacy of primary precut techniques for biliary cannulation: a systematic review and meta-analysis.Clinical endoscopy · 2026Article
- Technical factors associated with biliary cannulation success after transpancreatic precut sphincterotomy.Endoscopy international open · 2026Article
- Difficult biliary cannulation during ERCP: techniques and an evidence-informed practical algorithm.Frontiers in medicine · 2026Review
- Strategies for achieving successful cannulation in endoscopic retrograde cholangiopancreatography: A technical overview.World journal of gastrointestinal endoscopy · 2025Review
- Article
- Development of a Scoring System for Predicting the Difficulty of Bile Duct Cannulation and Selecting the Appropriate Cannulation Method.Digestive diseases and sciences · 2025Article
- Long-term prognosis and risk factors associated with 30-day unplanned repeated ERCP in patients with common bile duct stones.Therapeutic advances in gastroenterology · 2025Article
- Endoscopic nasobiliary drainage is superior to biliary stent placement in preventing postendoscopic papillary balloon dilation pancreatitis.Therapeutic advances in gastroenterology · 2025Article
- Optimal timing for discontinuation of ERCP in cases of difficult selective biliary cannulation.Endoscopy international open · 2025Article
- Impact of major duodenal papilla morphology on the outcomes of primary needle-knife fistulotomy for deep biliary cannulation.Scientific reports · 2024Article
- Impact of Duodenal Papilla Morphology on the Success of Transpancreatic Precut Sphincterotomy.Journal of clinical medicine · 2024Article
- Impact of duodenal papilla anatomy on needle knife papillotomy safety and efficacy in patients with difficult biliary canulation.BMC surgery · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe investigated whether duodenal major papilla morphology could be a risk factor for failure of selective biliary cannulation (SBC) and post endoscopic retrograde cholangiography and pancreatography (ERCP) complications.
methodsA prospectively recorded database was reviewed retrospectively. Patients were included if they received therapeutic ERCP and had naïve major duodenal papilla. We used Haraldsson's classification for papilla morphology, as follows: Regular (Type 1), Small (Type 2), Protruding or Pendulous (Type 3) and Creased or Ridged (Type 4). Risk factors for failing SBC and post-ERCP complications were analyzed by multivariate analysis.
resultsA total of 286 cases were included. Age, gender, indications and therapeutic procedures were not different among the four types of papillae. The failure rates of SBC with Type 3 papilla and Type 4 papilla were 11.11% and 6.25%, respectively. In the multivariate analysis, Type 2 papilla (odd ratio 7.18, p = 0.045) and Type 3 papilla (odd ratio 7.44, p = 0.016) were associated with greater SBC failure compared with Type 1 papilla. Malignant obstruction compared to stone (odds ratio 4.45, p = 0.014) and age (odd ratio = 1.06, p = 0.010) were also risk factors for cannulation failure. Type 2 papilla was correlated with a higher rate of post-ERCP pancreatitis (20%, p = 0.020) compared to the other types of papilla However, papilla morphology was not a significant risk factor for any complications in the multivariate analysis.
conclusionSmall papilla and protruding or pendulous papilla are more difficult to cannulate compared to regular papilla. Small papilla is associated with a higher rate of post-ERCP pancreatitis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.