Department of Hepatobiliary Surgery, Taizhou Hospital, Linhai City, Taizhou, China.
Surg Laparosc Endosc Percutan Tech. 2022 Aug 1;32(4):462-465. doi: 10.1097/SLE.0000000000001068.
To assess titanium clip-dental floss traction-assisting endoscopy in patients with difficulty in cannulation into the papilla located at the lower, left or right side of the periampullary diverticulum.
Sixty-eight patients who had difficulty in cannulation into the papilla located at the lower, left, or right side of the periampullary diverticulum upon endoscopic retrograde cholangiopancreatography (ERCP) were recruited at Taizhou Hospital from July 2016 to June 2020. A random number table was used to divide the patients into an intervention (with titanium clip-dental floss traction) group and a control group (n=34 in each group). Patients in both groups underwent ERCP. The cannulation time, cannulation success rate, incidence of postprocedural complications after ERCP, hospitalization time, and hospitalization expenses in the 2 groups were compared.
The cannulation time was 15.3±4.1 minutes in the intervention group, which was less than that in the control group (25.7±6.5 min). The cannulation success rate was 77±12.1% in the intervention group, which was higher than that in the control group (43±16.7%). Postprocedural complications occurred in 2 patients in the intervention group and 6 patients in the control group, with no significant differences. The hospitalization time and expenses were 3.8±2.6 days and 11.1±6 thousand yuan in the intervention group, respectively, and 6.1±3.7 days and 18.2±8 thousand yuan in the control group, respectively. The differences were statistically significant ( P <0.05).
Titanium clip-dental floss traction-assisting endoscopy achieved excellent efficacy in patients with difficulty in cannulation into the papilla located at the lower, left or right side of the periampullary diverticulum. The cannulation success rate was improved after treatment, with good safety and prognosis.
评估钛夹-牙线牵引辅助内镜技术在经内镜逆行胰胆管造影（ERCP）时乳头位于胰胆管憩室下、左或右侧患者插管困难的辅助作用。
2016 年 7 月至 2020 年 6 月，台州医院共招募了 68 例经 ERCP 插管困难的胰胆管憩室下、左或右侧乳头患者，采用随机数字表法将患者分为干预组（钛夹-牙线牵引）和对照组（每组 34 例）。两组患者均行 ERCP，比较两组患者的插管时间、插管成功率、ERCP 术后并发症发生率、住院时间及住院费用。
干预组插管时间为 15.3±4.1 分钟，短于对照组（25.7±6.5 分钟）；干预组插管成功率为 77±12.1%，高于对照组（43±16.7%）。干预组术后并发症 2 例，对照组 6 例，两组比较差异无统计学意义。干预组住院时间和费用分别为 3.8±2.6 天和 11.1±6 千元，对照组分别为 6.1±3.7 天和 18.2±8 千元，两组比较差异均有统计学意义（ P <0.05）。
钛夹-牙线牵引辅助内镜技术对胰胆管憩室下、左或右侧乳头插管困难患者具有良好的疗效，可提高插管成功率，安全性及预后良好。
