ArticleGland surgery2022
Comparison between pancreatic duct guide wire-assisted needle knife precut and conventional needle knife precut for periampullary diverticula with difficult cannulation: a retrospective comparative cohort study.
Article in Gland surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 2 citations in OpenAlex.
- Pancreatic guidewire-assisted fistulotomy versus transpancreatic biliary sphincterotomy in difficult biliary cannulation with unintentional pancreatic duct cannulation: A randomized clinical trial.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Trial
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3 authors at 1 institution in 1 country.
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Abstract
Background: Periampullary diverticula (PAD) often detected during endoscopic retrograde cholangiopancreatography (ERCP), and ERCP remains the primary approach to treating bile duct stones, and papilla cannulation plays a critical role in the success of ERCP. PAD can reduce the cannulation success rate. Needle knife precut greatly promoted the clinical application of precut incision. However, this approach also increases the risk of various adverse events. The present study aimed to compare the perioperative outcomes of pancreatic duct guide wire-assisted needle knife precut and conventional needle knife precut for PAD with difficult cannulation. Methods: A total of 230 cases of PAD with difficult cannulation of the duodenal papilla diagnosed by ERCP between June 2009 and December 2021 were retrospectively reviewed. The exclusion criteria were set as follows: patients with ERCP history, coagulopathy prothrombin time two times longer or platelet (PLT) count ≤70×10 Results: The operating time of the needle knife precut was significantly shorter in Group A (18.44±6.65 min) compared with Group B (32.05±13.15 min, P<0.01). Moreover, the success rate of the cannulation was markedly higher in Group A (100%, 135/135) compared with Group B (78.9%, 75/95). Intraoperative complications occurred in 15 (11.1%) and 26 (27.4%) cases in Groups A and B, respectively (P<0.01). Postoperative complications occurred in 10 (7.4%) and 17 (17.9%) cases in Groups A and B, respectively (P<0.01). Our results showed notable differences in the operating time, success rate of cannulation, intraoperative complication rates, and postoperative complication rates between the two approaches. Conclusions: Pancreatic duct guide wire-assisted needle knife precut appeared to be a safe and effective modality for PAD with difficult cannulation in the duodenal papilla.
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