Endoscopic Retrograde Cholangiopancreatography, Pancreaticobiilary Diseases
Conditions
Keywords
ERCP, anatomy of major duodenal papilla
Brief summary
Selective cannulation is an essential step for the success of ERCP. The successful cannulation is influenced by types of disease (such as Sphincter of Oddi Dysfunction and duodenal stricture), the experience of endoscopists and the anatomy of papilla. It is suggested that the size, morphology, orientation and location of major duodenal papilla (MDP), could cause a difficult cannulation (Endoscopy 2016; 48: 657-683). However, the related evidences are limited. The investigators hypothesized that special anatomy of papilla, such as a lanky shape (defined by the higher ratio of length to width) and a deeper location, could increase the difficulty of cannulation. Here the investigators investigated the effects of the anatomy of major duodenal papilla on post-ERCP pancreatitis and the procedure of cannulation in patients undergoing ERCP.
Interventions
OTHERMDP
evaluate the anatomy of each major duodenal papilla before selective cannulation during ERCP
Sponsors
The Second Affiliated Hospital of Chongqing Medical University
Huaihe Hospital of Henan University
Successful Hospital of Xiamen university
Air Force Military Medical University, China
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* age 18-80 * Patients with native papilla who underwent ERCP
Exclusion criteria
* Prior endoscopic sphincterotomy * Minor pancreatic duct as the targeted duct * History of prior upper gastrointestinal surgery, such as Billroth I, II and Roux-en-Y * Fistula of MDP * Papillary carcinoma or adenoma * Duodenal obstruction, type II * Prior stent placement in common bile duct or pancreatic duct * Pregnant or breastfeeding women * Unwilling or inability to provide consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| post-ERCP pancreatitis incidence | 48 hours | frequency of post-ERCP pancreatitis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of difficult cannulation | 3 hours | difficult cannulation was defined as when total cannulation time was more than 5minutes, total cannulation attempts more than 5 times or inadvertent pancreatic duct cannulation more than 1 time. |
| Cannulation attempts | 3 hours | the sphincterotome touching the papilla for at least 5 seconds will be considered as one attempt. |
| Total cannulation time | 3 hours | the time from the moment the sphincterotome touch the papilla to the guide wire advance into the target duct. |
| Unintended pancreatic duct cannulation | 3 hours | the guide wire unintentionally entered into the undesired pancreatic duct |
| Complication rate | 48 hours | frequency of any adverse outcome that required hospital admission or prolonged hospital stay necessary for management of the complication, including pancreatitis, bleeding, biliary infection or perforation. |
Countries
China
Outcome results
None listed