Therapeutic Endoscopy, Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah, Salt Lake City, Utah, USA.
J Clin Gastroenterol. 2010 Mar;44(3):e57-62. doi: 10.1097/MCG.0b013e3181aacbd1.
Deep biliary cannulation (DBC) is a prerequisite to most endoscopic retrograde cholangiopancreatographies (ERCPs). Numerous techniques have been described to maximize success and minimize ERCP-related complications, most notably post-ERCP pancreatitis. Dye-free cannulation by using guidewires with hydrophilic tips has been proposed as a technique with a high rate of success and a low rate of complications. We report the outcomes 822 consecutive ERCP procedures by using dye-free guidewire cannulation techniques.
To evaluate the success rate for DBC and rates of complications by using dye-free guidewire cannulation techniques.
Retrospective. Consecutive ERCP procedures with intent to achieve DBC exclusively by using dye-free guidewire technique were included. Complication data on post-ERCP pancreatitis, bleeding, perforation, and cholangitis were extracted.
University.
Patients undergoing biliary ERCP.
ERCP.
Success, complication rates.
Eight hundred and twenty-two ERCPs were performed on 744 patients. Five hundred and fifty-nine (68%) procedures were performed on inpatients, 263 (32%) on outpatients. DBC was successful in 801 of 822 (97%) ERCPs. In 795 of 801 (99%) ERCPs with successful DBC procedures, DBC was achieved in a dye-free fashion. Eleven patients (1.3%) developed post-ERCP pancreatitis-all cases were mild. Guidewire perforations occurred 11 times (1.3%), none required surgery. Ten of 11 patients with known or suspected (91%) guidewire perforation achieved successful DBC on repeat ERCP by the same endoscopist by using dye-free techniques.
Retrospective.
In this large retrospective case series, a high success rate of DBC was achieved by using dye-free guidewire techniques. This technique has associated lower rates of complications in comparison to those reported earlier.
深度胆管插管（DBC）是大多数内镜逆行胰胆管造影术（ERCP）的前提。为了最大限度地提高成功率并减少与 ERCP 相关的并发症，已经描述了许多技术，尤其是 ERCP 后胰腺炎。使用亲水尖端导丝进行无染料插管已被提出为一种成功率高且并发症发生率低的技术。我们报告了 822 例连续 ERCP 手术中使用无染料导丝插管技术的结果。
评估使用无染料导丝插管技术进行 DBC 的成功率和并发症发生率。
回顾性。包括旨在仅通过无染料导丝技术实现 DBC 的连续 ERCP 手术。提取了关于 ERCP 后胰腺炎、出血、穿孔和胆管炎的并发症数据。
大学。
接受胆道 ERCP 的患者。
ERCP。
成功率，并发症发生率。
822 例 ERCP 在 744 例患者中进行。559 例（68%）为住院患者，263 例（32%）为门诊患者。822 例 ERCP 中有 801 例（97%）插管成功。在 801 例 DBC 成功的 ERCP 中，795 例（99%）以无染料的方式实现了 DBC。11 例（1.3%）患者发生 ERCP 后胰腺炎，均为轻度。导丝穿孔发生 11 次（1.3%），均无需手术。11 例已知或疑似（91%）导丝穿孔患者中，10 例由同一位内镜医生在重复 ERCP 时使用无染料技术成功实现 DBC。
回顾性。
在这项大型回顾性病例系列研究中，使用无染料导丝技术实现了 DBC 的高成功率。与早期报道相比，该技术的并发症发生率较低。
