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Atsushi Urata 2 Articles
Factors Predicting Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography for Common Bile Duct Stones
Hirokazu Saito, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Haruo Imamura, Ikuo Matsushita, Tatsuyuki Kakuma, Shuji Tada
Clin Endosc 2022;55(2):263-269.   Published online November 12, 2021
DOI: https://doi.org/10.5946/ce.2021.153
AbstractAbstract PDFPubReaderePub
Background
/Aims: Difficult biliary cannulation is an important risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Therefore, this study aimed to identify the factors that predict difficult cannulation for common bile duct stones (CBDS) to reduce the risk for PEP.
Methods
This multicenter retrospective study included 1,406 consecutive patients with native papillae who underwent ERCP for CBDS. Factors predicting difficult cannulation for CBDS were identified using univariate and multivariate analyses.
Results
Univariate analysis showed that six factors significantly predicted difficult cannulation: ERCP performed by non-expert endoscopists, low-volume center, absence of acute cholangitis, normal serum bilirubin, intradiverticular papilla, and type of major duodenal papilla. Multivariate analysis identified ERCP performed by non-expert endoscopists (odds ratio [OR], 2.5; p<0.001), low-volume center (OR, 1.6; p<0.001), intradiverticular papilla (OR, 1.3; p=0.007), normal serum bilirubin (OR, 1.3; p=0.038), and absence of acute cholangitis (OR, 1.3; p=0.049) as factors significantly predicting difficult cannulation for CBDS.
Conclusions
Initial cannulation by an experienced endoscopist, early rescue cannulation, or early takeover by an experienced endoscopist should be considered when performing ERCP for CBDS in the presence of factors predicting difficult cannulation.

Citations

Citations to this article as recorded by  
  • Advancements in Research on Challenges in Selective Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography (ERCP)
    天雨 张
    Journal of Clinical Personalized Medicine.2024; 03(01): 100.     CrossRef
  • The impact of transpancreatic precut sphincterotomy on the quality of ERCP in a low-volume setting
    Wei-Chih Su, Chia-Chi Wang, Tsung-Hsien Hsiao, Hung-Da Chen, Jiann-Hwa Chen
    Gastrointestinal Endoscopy.2024; 99(5): 747.     CrossRef
  • Morphology of the papilla can predict procedural safety and efficacy of ERCP—a systematic review and meta-analysis
    Edina Tari, Endre Botond Gagyi, Anett Rancz, Dániel Sándor Veres, Szilárd Váncsa, Péter Jenő Hegyi, Krisztina Hagymási, Péter Hegyi, Bálint Erőss
    Scientific Reports.2024;[Epub]     CrossRef
  • Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
    Hyung Ku Chon, Ki-Hyun Kim, Tae Jun Song, Dong-Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyun Chung, Jin Lee, Miyoung Choi
    Gut and Liver.2024; 18(4): 564.     CrossRef
  • En face position of the major duodenal papilla using a reopenable clip during endoscopic retrograde cholangiopancreatography
    Hirokazu Saito, Akiko Ikebata, Shunpei Hashigo
    Digestive Endoscopy.2023;[Epub]     CrossRef
  • Criterios 5-5-2 de canulación biliar y complicaciones post colangiopancreatografía retrógrada endoscópica: Experiencia en un hospital de referencia, Perú
    Wilmer Gustavo Quiroga Purizaca, Diego Ricardo Páucar Aguilar, Jackeline Amparo Barrientos Pérez, Isamar Benyi Gutiérrez Córdova, Renato Garrido Acedo, Daniel Andrei Vargas Blácido
    Revista de Gastroenterología del Perú.2023; 43(2): e1461.     CrossRef
  • Predictive factors of difficult biliary cannulation: An experience of a tunisian tertiary center
    K. Ben Abdallah, L. Hamzaoui, M. Mahmoudi, I. Cherif, A. Ben Mohamed, M. Yakoubi, A. Khsiba, M. Medhioub, M.M. Azouz
    Heliyon.2022; 8(12): e12526.     CrossRef
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Synergistic effect of independent risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis: a multicenter retrospective study in Japan
Hirokazu Saito, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Masayoshi Uehara, Ikuo Matsushita, Tatsuyuki Kakuma, Shunpei Hashigo, Shuji Tada
Received August 14, 2023  Accepted October 10, 2023  Published online April 18, 2024  
DOI: https://doi.org/10.5946/ce.2023.203    [Epub ahead of print]
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: This study aimed to examine the synergistic effect of independent risk factors on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
Methods
This multicenter retrospective study included 1,273 patients with native papillae who underwent ERCP for bile duct stones in Japan. Independent PEP risk factors were identified using univariate and multivariate analyses. Significant risk factors for PEP in the multivariate analysis were included in the final analysis to examine the synergistic effect of independent risk factors for PEP.
Results
PEP occurred in 45 of 1,273 patients (3.5%). Three factors including difficult cannulation ≥10 minutes, pancreatic injection, and normal serum bilirubin level were included in the final analysis. The incidences of PEP in patients with zero, one, two, and three factors were 0.5% (2/388), 1.9% (9/465), 6.0% (17/285), and 12.6% (17/135), respectively. With increasing risk factors for PEP, the incidence of PEP significantly increased (1 factor vs. 2 factors, p=0.006; 2 factors vs. 3 factors, p=0.033).
Conclusions
As the number of risk factors for PEP increases, the risk of PEP may not be additive; however, it may multiply. Thus, aggressive prophylaxis for PEP is strongly recommended in patients with multiple risk factors.
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