Post-ERCP Acute Pancreatitis
Conditions
Brief summary
This observational, prospective study aims at evaluating how the occurrence of post-Endoscopic Retrograde CholangioPancreatography (ERCP) acute pancreatitis (PEP) could be influenced by difficult biliary cannulation that might be previously assessed by the morphological appearance of native major papilla in all the patients undergoing ERCP. The rate of successful biliary cannulation across papilla types could be used as intraprocedural quality and competence metrics during training. Moreover, recognizing difficult papillae could allow reserving those to experts to decrease the odds of failed cannulation.
Interventions
ERCP performed for clinical practice
Sponsors
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patients with native duodenal papilla; * Any indication to ERCP +/- biliary sphincterotomy of duodenal major papilla; * Patients able to provide a written informed consent
Exclusion criteria
* ERCP performed for disorders unrelated to biliary tract; * Previous upper gastrointestinal tract surgery; * Presence of a duodenal stricture (either malignant or benign); * Presence of a malignant infiltration of the papilla; * Concomitant anticoagulant and/or P2Y12 inhibitors therapy (clopidogrel, prasugrel, ticagrelor) that precludes the treatment; * INR \> 1.5; * Platelets count \< 80000/mm3; * Unwillingness to sign written informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of PEP occurrence | within 48 hours after the procedure | Rate of PEP occurrence distributed between the different native major duodenal papilla types |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of difficult biliary cannulation | during the procedure | Rate of difficult biliary cannulation (\> 5 cannulation attempts and/or \> 5 minutes attempting to cannulate biliary duct and/or at least one passage in the pancreatic duct) distributed between the different native major duodenal papilla types |
| Rate of intraoperative complications | during the procedure | Rate of intraoperative complications distributed between the different native major duodenal papilla types |
| Rate of postoperative complications except for PEP | within 48 hours after the procedure | Rate of postoperative complications except for PEP (up to 48 hours after ERCP) distributed between the different native major duodenal papilla types |
| Difference in the rate of difficult biliary cannulation | during the procedure | Difference in the rate of difficult biliary cannulation between ERCP experts (\>300 performed procedures) and fellows (\<300 performed procedures) |
| occurrence of intra- and post-procedural complications | within 48 hours after the procedure | To evaluate the occurrence of intra- and post-procedural complications but PEP, fluoroscopic morphology of the papillary segment of distal bile duct, perioperative and intraoperative risk factors |
Countries
Italy
Contacts
Primary ContactIvo Boskoski
Outcome results
None listed