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The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri Jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly Gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA Department of Gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly Gastroenterology and Digestive Endoscopy Unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA Department of Gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of Gastroenterology HyderabadIndia Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 ***: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

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Effect of endoscopic sphincterotomy and endoscopic papillary balloon dilation endoscopic retrograde cholangiopancreatographies on the sphincter of Oddi

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1726-1733页

作者： Kai Fu Ying-Ying Yang Hui Chen Guang-Xin Zhang Yan Wang Zhi Yin Department of Gastroentero Endoscopy Center Yixing Hospital of Traditional Chinese MedicineWuxi 214200Jiangsu ProvinceChina

BACKGROUND endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for *** To investigate the effects of different ERCP procedures on the sphincter of *** The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed *** patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)*** duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction in the EST and EPBD *** Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not *** significant differences were observed between the two groups concerning sex and age(<60 years).Patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction were higher in the EST group than in the EPBD *** number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD *** number of Oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD *** numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD *** In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and *** on this evidence,this study can provide

关键词： Oddi Cholangiopancreatography endoscopic retrograde Risk factors endoscopic sphincterotomy endoscopic papillary balloon dilation

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Predictors of recurrent bile duct stone after clearance by endoscopic retrograde cholangiopancreatography:A case-control study

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 50-55页

作者： Wisam Sbeit Anas Kadah Matta Simaan Amir Shahin Tawfik Khoury Department of Gastroenterology Galilee Medical CenterNahariyaIsrael Faculty of Medicine in the Galilee Bar-Ilan UniversitySafedIsrael

Background:Recurrent common bile duct(CBD)stone is a long-term sequalae among patients who un-derwent endoscopic retrograde cholangiopancreatography(ERCP)with CBD stone *** regard-ing risk factors for recurrent CBD stone are *** aimed to identify predictors of recurrent CBD ***:We performed a retrospective case-controlled study from January 2010 to December ***-clusion criteria included patients who had recurrent CBD stone at least 6 months after the index ERCP,in which complete stone extraction was performed and normal cholangiogram was ***,457 patients were ***-two patients(9.2%)had recurrent CBD stone,and 415 patients(90.8%)did not have recurrent CBD ***:In univariate analysis,male sex[odds ratio(OR)=0.49,P=0.033]was a protective factor,while endoscopic stone extraction by basket ***(OR=2.55,P=0.005),older age(OR=1.03,P=0.003),number of CBD stones(OR=1.99,P=0.037),size of CBD stone(OR=4.06,P=0.003)and mechanical lithotripsy(OR=9.22,P=0.004)were risk factors for recurrent CBD *** multivariate logistic regression analysis,mechanical lithotripsy[OR=9.73,95%confidence interval(CI):1.69-55.89,P=0.010],basket clearance *** basket and balloon(OR=18.25,95%CI:1.05-318.35,P=0.046)and older age(OR=1.02,95%CI:1.00-1.05,P=0.023)were risk factors,and male sex(OR=0.39,95%CI:0.19-0.81,P=0.012)was a protective factor.

关键词： endoscopic retrograde cholangiopancreatography Common bile duct Stone Recurrence

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Risk factors for post-endoscopic retrograde cholangiopancreatography(ERCP) abdominal pain in patients without post-ERCP pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 285-292页

作者： Meng-Jie Chen Ru-Hua Zheng Jun Cao Yu-Ling Yao Lei Wang Xiao-Ping Zou Department of Gastroenterology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjingChina Department of Gastroenterology Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingChina

Background:Abdominal pain is often observed after endoscopic retrograde cholangiopancreatography(ERCP).Few studies have focused on the risk factors of post-ERCP abdominal pain without post-ERCP pancreatitis(PEP).This study aimed to identify risk factors of post-ERCP abdominal pain without PEP and investigate characteristics of the abdominal pain in non-PEP ***:Data from patients who underwent ERCP from August 2019 to January 2020 were retrospectively *** of the abdominal pain after ERCP were recorded and compared between PEP and non-PEP *** analysis was conducted to identify risk factors of non-PEP abdominal ***:A total of 1295 ERCP procedures were investigated in this study,among which 100(7.72%)patients presented post-ERCP abdominal pain without PEP and 63(4.86%)patients with *** analysis found 9 risk factors of non-PEP abdominal pain:age≤65 years[odds ratio(OR):1.971],primary ERCP(OR:2.442),dilated extrahepatic bile duct(OR:1.803),no papilla opening(OR:2.095),pancreatic guidewire passages(OR:2.258),white blood cells(WBC)≤6.0×10^(9)/L(OR:1.689),platelet(PLT)≤250×10^(9)/L(OR:2.505),serumγ-glutamyl transferase(γ-GT)≤35 U/L(OR:2.190),and albumin≥40 g/L(OR:1.762).The PEP group had later pain onset,higher pain frequency and longer hospital stay than those of the non-PEP pain group(P0.05).Conclusions:This study indicated that age≤65 years,primary ERCP,dilated extrahepatic bile duct,no papilla opening,pancreatic guidewire passages,lower WBC,lower PLT,normalγ-GT and elevated albumin were independent risk factors for post-ERCP abdominal pain without *** pain occurred earlier in non-PEP patients than in PEP patients.

关键词： Post-ERCP abdominal pain Cholangiopancreatography endoscopic retrograde Pancreatitis Risk factor

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Risk factors of recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography

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Hepatobiliary & Pancreatic Diseases International 2023年第3期22卷 282-287页

作者： Lin Li Jing Wang Cheng-Cheng Tong Chi-Yi He Department of Gastroenterology The First Affiliated Hospital of Wannan Medical CollegeWuhu 241001China

Background:The risk factors for the recurrent choledocholithiasis after endoscopic retrograde cholangiopancreatography(ERCP)have not been well *** aim of this study was to explore the risk factors of recurrent ***:We carried out a retrospective analysis of data collected between January 1,2010 and January 1,*** analysis and multivariate analysis were used to explore the independent risk factors of recurrent choledocholithiasis following therapeutic ***:In total,598 patients were eventually selected for analysis,299 patients in the recurrent choledocholithiasis group and 299 patients in the control *** overall rate of recurrent choledocholithiasis was 6.91%.Multivariate analysis showed that diabetes[odds ratio(OR)=3.677,95%confidence interval(CI):1.875-7.209;Pendoscopic papillary balloon dilation(EPBD)(OR=3.009,95%CI:1.921-4.715;P<0.001)were independent risk factors of recurrent ***,history of drinking(OR=0.183,95%CI:0.099-0.337;P<0.001),eating light food frequently(OR=0.511,95%CI:0.343-0.760;P=0.001),and antibiotic use before ERCP(OR=0.315,95%CI:0.200-0.497;P<0.001)were independent protective factors of recurrent ***:Patients with the abovementioned risk factors are more likely to have recurrent CBD *** who eat light food frequently and have a history of drinking are less likely to present with recurrent CBD calculi.

关键词： Recurrence Choledocholithiasis endoscopic retrograde cholangiopancreatography

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Changing pattern of indications of endoscopic retrograde cholangiopancreatography in children and adolescents:a twelve-year experience

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World Journal of Pediatrics 2015年第2期11卷 154-159页

作者： Carlos O Kieling Cristiane Hallal Camila O Spessato Luciana M Ribeiro Helenice Breyer Helena AS Goldani Ismael Maguilnik Post-Graduate Program of Sciences in Gastroenterology and Hepatology Universidade Federal do Rio Grande do Sul Pediatric Gastroenterology Unit Hospital de Clínicas de Porto AlegreFaculdade de MedicinaUniversidade Federal do Rio Grande do SulBrazil Endoscopy Service Hospital de Clínicas de Porto AlegreFaculdade de MedicinaUniversidade Federal do Rio Grande do SulBrazil

Background:There are few data regarding endoscopic retrograde cholangiopancreatography(ERCP)usefulness in children and *** reviewed the long-term experience with diagnostic and therapeutic ERCP in a tertiary single center in Southern ***:A retrospective chart review of patients aged 0-18 years who had undergone ERCPs from January 2000 to June 2012 was *** on demographics,indications,diagnosis,treatments,and complications were ***:Seventy-five ERCPs were performed in 60 *** median age of the patients at the procedure was 13.9 years(range:1.2-17.9).Of the 60 patients,47(78.3%)were *** all ERCPs,48(64.0%)were performed in patients above 10 years and 35(72.9%)of them were in *** was indicated for patients with bile duct obstruction(49.3%),sclerosing cholangitis(18.7%),post-surgery complication(12%),biliary stent(10.7%),choledochal cyst(5.3%),and pancreatitis(4%).The complication rate of ERCP was 9.7%involving mild bleeding,pancreatitis and *** who had therapeutic procedures were older(13.7±3.9 vs.9.9±4.9 years;P=0.001)and had more extrahepatic biliary abnormalities(82%vs.50%;P=0.015)than those who had diagnostic ERCPs.A marked change in the indications of ERCPs was found,i.e.,from 2001 to 2004,indications were more diagnostic and from 2005 therapeutic procedures were ***:Diagnostic ERCPs are being replaced by magnetic resonance cholangiopancreatography and also by endoscopic *** these procedures are complementary and ERCP still has a role for therapeutic purposes.

关键词： adolescents cholangiopancreatography endoscopic retrograde

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Machine learning models compared to existing criteria for noninvasive prediction of endoscopic retrograde cholangiopancreatography-confirmed choledocholithiasis

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Liver Research 2021年第4期5卷 224-231页

作者： Camellia Dalai John M Azizian Harry Trieu Anand Rajan Formosa C Chen Tien Dong Simon W Beaven James H.Tabibian UCLA-Olive View Internal Medicine Residency Program Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA Keck School of Medicine University of Southern CaliforniaLos AngelesCAUSA Department of Surgery David Geffen School of Medicine at UCLALos AngelesCAUSA Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesCAUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance *** aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained *** logistic regression was used to identify predictors of ERCP-confirmed *** were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to ***:We identified 270 patients(mean age 46 years,62.2%female,73.7%Hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed *** regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed *** the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,*** high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD di

关键词： Machine learning models(MLMs) endoscopic retrograde cholangiopancreatography(ERCP) Noninvasive imaging Bile duct disorders Common bile duct stones Gallstones

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endoscopic retrograde cholangiopancreatography:Current practice and future research

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 260-274页

作者： David J Sanders Shivanand Bomman Rajesh Krishnamoorthi Richard A Kozarek Digestive Disease Institute Virginia Mason Medical CenterSeattleWA 98101United States

endoscopic retrograde cholangiopancreatography(ERCP)has evolved from a primarily diagnostic to therapeutic procedure in hepatobiliary and pancreatic *** commonly,ERCPs are performed for choledocholithiasis with or without cholangitis,but improvements in technology and technique have allowed for management of pancreatic duct stones,benign and malignant strictures,and bile and pancreatic *** an example of necessity driving innovation,the new disposable duodenoscopes have been introduced into *** the advantage of eliminating transmissible infections,they represent a paradigm shift in quality improvement within *** procedures becoming more complicated,the necessity for anesthesia involvement and safety of propofol use and general anesthesia has become better *** improvements in endoscopic ultrasound(EUS)have allowed for direct bile duct access and EUS facilitated bile duct access for *** patients with surgically altered anatomy,selective cannulation can be performed with overtube-assisted enteroscopy,laparoscopic surgery assistance,or the EUS-directed transgastric *** and pancreatoscopy use has become ubiquitous with defined indications for large bile duct stones,indeterminate strictures,and hepatobiliary and pancreatic *** review summarizes the recent advances in infection prevention,quality improvement,pancreaticobiliary access,and management of hepatobiliary and pancreatic *** appropriate,future research directions are included in each section.

关键词： Cholangiopancreatography endoscopic retrograde Cholangioscopy Cannulation endoscopic ultrasound Disposable duodenoscopes

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Timing of early laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography

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Laparoscopic, endoscopic and Robotic Surgery 2020年第2期3卷 39-42页

作者： Min Zhang Wenyi Hu Mingjie Wu Guoping Ding Songmei Lou Liping Cao Department of Hepatobiliary&Pancreatic Surgery Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of Critical Care Medicine Ningbo Ninth HospitalNingbo 315020China

Objective:This study was performed to compare the effect of different time intervals between endoscopic retrograde cholangiopancreatography(ERCP)and early laparoscopic cholecystectomy(LC)on the operation duration,postoperative hospitalization,and postoperative *** and methods:We retrospectively reviewed data for 105 patients with cholecystocholedocholithiasis who underwent ERCP and LC from January 2016 to May *** patients were divided into three *** Group A,the interval from ERCP to LC was3 days;in Group B,the interval was 4e6 days;and in Group C,the interval was>6 *** compared operation duration,blood loss volume,postoperative hospitalization,and rate of biliary complications among the three groups and analyzed the risk factors for postoperative ***:Operation duration differed significantly between Groups A and B(47.5 min vs.60.0 min,p?0.033)and between Groups B and C(60.0 min vs.47.5 min,p?0.033).The median blood loss volume was significantly less in Group A than in Group B(8 ml vs.10 ml,p?0.041),and the postoperative hospitalization and rate of postoperative complications did not differ ***:The best time for patients with cholecystocholedocholithiasis to undergo LC is 0e3 days after *** the operation cannot be performed within 3 days,we recommend 6 days after ERCP.

关键词： Cholecystocholedocholithiasis endoscopic retrograde cholangiopancreatography Laparoscopic cholecystectomy Time interval

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Splenic laceration following endoscopic retrograde cholangiopancreatography:A literature review and our experience

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Laparoscopic, endoscopic and Robotic Surgery 2020年第3期3卷 80-84页

作者： Kan Wang Yanfei Fang Aihua Huang Min Gao Department of Gastroenterology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of Pathology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China

endoscopic retrograde cholangiopancreatography(ERCP)is an invasive procedure,which is widely used in the management of pancreas and biliary tract *** may induce complications,such as pancreatitis,bleeding,and *** injury is an extremely rare but life threatening *** reviewed the literature,and found that 23 ERCP associated splenic injuries cases had been *** discussed the likely mechanism,clinical features,diagnostic modality,and treatment,also shared our experience on a patient who suffered splenic laceration after ERCP and was successfully treated by splenectomy.

关键词： endoscopic retrograde cholangiopancreatography Complication Splenic injury

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