Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, 520-2192, Japan.
Department of General Medicine, Sapporo Medical University, Sapporo, Japan.
BMC Gastroenterol. 2021 Mar 4;21(1):102. doi: 10.1186/s12876-021-01689-6.
We investigated the utility and safety of a new uneven double-lumen sphincterotome in biliary cannulation in comparison with the conventional pancreatic guidewire (PGW) method.
We retrospectively evaluated 119 patients who required PGW placement because of difficult biliary cannulation. Endoscopic retrograde cholangiopancreatography (ERCP) was performed using a conventional ERCP catheter or a new uneven double-lumen sphincterotome. The success rate of bile duct cannulation, the operation time of bile duct cannulation, and the incidence of post-ERCP pancreatitis (PEP) were evaluated.
Forty-four patients were treated with a new double-lumen sphincterotome (the new sphincterotome group) and 75 patients underwent conventional PGW placement (the conventional group). The success rate of bile duct cannulation was 39/44 (88.6%) in the new sphincterotome group and 63/75 (84.0%) in the conventional group (not significant). The total biliary cannulation time (from the reach to the papilla to the finish of biliary cannulation) was 16.0 (6.5-78) min in the new sphincterotome group and 26.0 (5-80) min in the conventional group (P < 0.01). The time from PGW placement to bile duct cannulation was 3.5 (0.3-57) min in the magictome group and 12.0 (1-65) min in the conventional group (P < 0.01). Hyperamylasemia was observed in 13/44 (29.5%) and 17/75 (22.7%), respectively (not significant). Five of 44 (11.3%) of the new sphincterotome group and 14/75 (18.7%) of the conventional group were diagnosed with PEP (not significant).
A new double-lumen sphincterotome allows selective bile duct cannulation to be performed in a shorter time than the conventional PGW method.
我们研究了一种新型非均匀双腔括约肌切开刀在胆管插管中的应用效果和安全性，并与传统的胰管导丝（PGW）方法进行了比较。
我们回顾性评估了 119 例因胆管插管困难而需要 PGW 置管的患者。使用常规 ERCP 导管或新型非均匀双腔括约肌切开刀进行内镜逆行胰胆管造影（ERCP）。评估胆管插管成功率、胆管插管操作时间和 ERCP 后胰腺炎（PEP）的发生率。
44 例患者采用新型双腔括约肌切开刀治疗（新型切开刀组），75 例患者采用传统 PGW 置管（传统组）。新型切开刀组胆管插管成功率为 39/44（88.6%），传统组为 63/75（84.0%）（无显著性差异）。新型切开刀组总胆管插管时间（从到达乳头到完成胆管插管）为 16.0（6.5-78）min，传统组为 26.0（5-80）min（P<0.01）。从 PGW 置管到胆管插管的时间在新型切开刀组为 3.5（0.3-57）min，在传统组为 12.0（1-65）min（P<0.01）。新型切开刀组发生高淀粉酶血症 13/44（29.5%），传统组为 17/75（22.7%）（无显著性差异）。新型切开刀组 5/44（11.3%）和传统组 14/75（18.7%）诊断为 PEP（无显著性差异）。
新型双腔括约肌切开刀选择性胆管插管时间短于传统 PGW 方法。
