Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study
Background. We developed a novel oblique-tip papillotome (OT-papillotome) to facilitate biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP). This study was performed to evaluate the utility of the OT-papillotome for contrast-guided cannulation (CGC) and wire-guided cannu...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/2417841 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832555138161573888 |
|---|---|
| author | Hiroo Imazu Shiaw-Hooi Ho Shoryoku Hino Khean-Lee Goh Mitsuhiko Moriyama Kazuki Sumiyama Hisao Tajiri |
| author_facet | Hiroo Imazu Shiaw-Hooi Ho Shoryoku Hino Khean-Lee Goh Mitsuhiko Moriyama Kazuki Sumiyama Hisao Tajiri |
| author_sort | Hiroo Imazu |
| collection | DOAJ |
| description | Background. We developed a novel oblique-tip papillotome (OT-papillotome) to facilitate biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP). This study was performed to evaluate the utility of the OT-papillotome for contrast-guided cannulation (CGC) and wire-guided cannulation (WGC) during ERCP, compared with standard cannulation by WGC using a standard-tip papillotome (ST-papillotome). Methods. A prospective study was performed at two centers. CGC with the OT-papillotome (OT-CGC group) was performed at Jikei University Hospital, while WGC was done with the OT-papillotome and ST-papillotome (OT-WGC and ST-WGC groups, respectively) at the University of Malaya Medical Centre. The results of the OT-CGC and OT-WGC groups were compared with those of the ST-WGC group after performing coarsened exact matching (CEM) to reduce bias due to nonrandomized and center-based patient allocation. Results. Eighty patients were enrolled in each of the OT-CGC, OT-WGC, and ST-WGC groups. After CEM, the successful biliary cannulation rate was significantly higher in the OT-CGC and OT-WGC groups than in the ST-WGC group, while rescue cannulation was reduced. The mean number of unintended pancreatic access events in the OT-WGC and OT-CGC groups was similar to the ST-WGC group. However, it was significantly lower in the OT-WGC group than in the OT-CGC group. Multivariate analysis revealed that the OT-papillotome was independently associated with less frequent rescue cannulation and a higher successful biliary cannulation rate. Conclusions. Although use of the OT-papillotome in biliary cannulation did not reduce unintended pancreatic access events or PEP compared to the ST-papillotome, the OT-papillotome increased the successful biliary cannulation rate, while reducing the frequency of rescue cannulation procedures. Combining the OT-papillotome with WGC might be the best cannulation technique for minimizing unintended pancreatic access. |
| format | Article |
| id | doaj-art-d81c5662b70748888883095d66d11d24 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-d81c5662b70748888883095d66d11d242025-02-03T05:49:30ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/24178412417841Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching StudyHiroo Imazu0Shiaw-Hooi Ho1Shoryoku Hino2Khean-Lee Goh3Mitsuhiko Moriyama4Kazuki Sumiyama5Hisao Tajiri6Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, JapanDivision of Gastroenterology, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, MalaysiaDepartment of Neuropsychiatry, Ishikawa Prefecture Takamatsu Hospital, Kahoku, JapanDivision of Gastroenterology, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, MalaysiaDivision of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, JapanDepartment of Endoscopy, The Jikei University School of Medicine, Tokyo, JapanDepartment of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, JapanBackground. We developed a novel oblique-tip papillotome (OT-papillotome) to facilitate biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP). This study was performed to evaluate the utility of the OT-papillotome for contrast-guided cannulation (CGC) and wire-guided cannulation (WGC) during ERCP, compared with standard cannulation by WGC using a standard-tip papillotome (ST-papillotome). Methods. A prospective study was performed at two centers. CGC with the OT-papillotome (OT-CGC group) was performed at Jikei University Hospital, while WGC was done with the OT-papillotome and ST-papillotome (OT-WGC and ST-WGC groups, respectively) at the University of Malaya Medical Centre. The results of the OT-CGC and OT-WGC groups were compared with those of the ST-WGC group after performing coarsened exact matching (CEM) to reduce bias due to nonrandomized and center-based patient allocation. Results. Eighty patients were enrolled in each of the OT-CGC, OT-WGC, and ST-WGC groups. After CEM, the successful biliary cannulation rate was significantly higher in the OT-CGC and OT-WGC groups than in the ST-WGC group, while rescue cannulation was reduced. The mean number of unintended pancreatic access events in the OT-WGC and OT-CGC groups was similar to the ST-WGC group. However, it was significantly lower in the OT-WGC group than in the OT-CGC group. Multivariate analysis revealed that the OT-papillotome was independently associated with less frequent rescue cannulation and a higher successful biliary cannulation rate. Conclusions. Although use of the OT-papillotome in biliary cannulation did not reduce unintended pancreatic access events or PEP compared to the ST-papillotome, the OT-papillotome increased the successful biliary cannulation rate, while reducing the frequency of rescue cannulation procedures. Combining the OT-papillotome with WGC might be the best cannulation technique for minimizing unintended pancreatic access.http://dx.doi.org/10.1155/2020/2417841 |
| spellingShingle | Hiroo Imazu Shiaw-Hooi Ho Shoryoku Hino Khean-Lee Goh Mitsuhiko Moriyama Kazuki Sumiyama Hisao Tajiri Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study Gastroenterology Research and Practice |
| title | Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study |
| title_full | Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study |
| title_fullStr | Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study |
| title_full_unstemmed | Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study |
| title_short | Impact of a Novel Oblique-Tip Papillotome for Biliary Cannulation during ERCP: A Nonrandomized Coarsened Exact Matching Study |
| title_sort | impact of a novel oblique tip papillotome for biliary cannulation during ercp a nonrandomized coarsened exact matching study |
| url | http://dx.doi.org/10.1155/2020/2417841 |
| work_keys_str_mv | AT hirooimazu impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT shiawhooiho impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT shoryokuhino impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT kheanleegoh impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT mitsuhikomoriyama impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT kazukisumiyama impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy AT hisaotajiri impactofanovelobliquetippapillotomeforbiliarycannulationduringercpanonrandomizedcoarsenedexactmatchingstudy |