Can early precut reduce post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with difficult bile duct cannulation?  

作　　者：Tomohiro Tanikawa Keisuke Miyake Mayuko Kawada Katsunori Ishii Takashi Fushimi Noriyo Urata Nozomu Wada Ken Nishino Mitsuhiko Suehiro Miwa Kawanaka Hidenori Shiraha Ken Haruma Hirofumi Kawamoto 

机构地区：[1]Department of General Internal Medicine 2,Kawasaki Medical School,Okayama 7008505,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第9期519-525,共7页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is associated with a variety of adverse events(AEs).One of the most important AEs is post-ERCP pancreatitis(PEP),which is most common in cases of difficult biliary cannulation.Although the precut technique has been reported as a PEP risk factor,recent studies indicate that early precut could reduce PEP,and that precut itself is not a risk factor.AIM To evaluate the safety of the precut technique,especially in terms of PEP.METHODS We conducted a retrospective study,spanning the period from November 2011 through December 2021.It included 1556 patients,aged≥20 years,who underwent their initial ERCP attempt for biliary disease with a naïve papilla at the Kawasaki University General Medical Center.We compared the PEP risk between the early precut and the delayed precut group.RESULTS The PEP incidence rate did not significantly differ between the precut and nonprecut groups.However,the PEP incidence was significantly lower in the early precut group than the delayed precut group(3.5%vs 10.5%;P=0.02).The PEP incidence in the delayed precut group without pancreatic stent insertion(17.3%)was significantly higher compared to other cases(P<0.01).CONCLUSION Our findings indicate that early precut may reduce PEP incidence.If the precut decision is delayed,a pancreatic stent should be inserted to prevent PEP.

关 键 词：Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis PRECUT Needle-knife precut papillotomy 

分 类 号：R576[医药卫生—消化系统]