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Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP

BACKGROUND: Demonstration of access to the bile duct through Enlarged Papillary Fistulotomy, a method different from conventional fistulotomy. AIMS: Demonstration of the EFP technique with dissection in layers of the papilla for accessing the common bile duct, its efficiency and safety, rescue of ca...

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Autores principales: Gomes, Alexandre, Haidar, Ana Sarah Rafka, Padilha, Giovani Caetano, Bara, Juliana, Nonato, Mariana Sussai, da Silva Rodrigues, José Mauro, Pinto, Pérsio Campos Correia, de Oliveira Ayres, Ricardo, Borghesi, Ronaldo Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687980/
https://www.ncbi.nlm.nih.gov/pubmed/38030984
http://dx.doi.org/10.1186/s12876-023-03013-w
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author Gomes, Alexandre
Haidar, Ana Sarah Rafka
Padilha, Giovani Caetano
Bara, Juliana
Nonato, Mariana Sussai
da Silva Rodrigues, José Mauro
Pinto, Pérsio Campos Correia
de Oliveira Ayres, Ricardo
Borghesi, Ronaldo Antonio
author_facet Gomes, Alexandre
Haidar, Ana Sarah Rafka
Padilha, Giovani Caetano
Bara, Juliana
Nonato, Mariana Sussai
da Silva Rodrigues, José Mauro
Pinto, Pérsio Campos Correia
de Oliveira Ayres, Ricardo
Borghesi, Ronaldo Antonio
author_sort Gomes, Alexandre
collection PubMed
description BACKGROUND: Demonstration of access to the bile duct through Enlarged Papillary Fistulotomy, a method different from conventional fistulotomy. AIMS: Demonstration of the EFP technique with dissection in layers of the papilla for accessing the common bile duct, its efficiency and safety, rescue of cases of failure in cannulation and cases of access failure by EFP in the first attempt, facilitating cannulation in the second attempt. METHODS: Cross-sectional study, with retrospective data collection from 2233 ERCP exams with 528 EFP procedures, analysis of success and complications. RESULTS: 528 patients underwent EFP on the first attempt, with success in 465 cases (88.06%) and 63 failures (11.94%). Of these failures, 33 patients (52.38%) returned for a second EFP attempt, with success in 30 cases (90.9%) and failure in 3 cases (9.1%). Deep bile duct cannulation was achieved in 93.75% of EFP procedures, and cannulation failure occurred in 33 cases (6.25%). CONCLUSION: EFP showed efficiency in CBD cannulation, did not induce post-ERCP pancreatitis, no cases of perforation or false tract, but resulted in higher rates of minor bleeding, rescued cases of access failure by EFP, facilitated the posterior approach on the second attempt, it is safe, effective, low risk and associated with few comorbidities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-023-03013-w.
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spelling pubmed-106879802023-11-30 Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP Gomes, Alexandre Haidar, Ana Sarah Rafka Padilha, Giovani Caetano Bara, Juliana Nonato, Mariana Sussai da Silva Rodrigues, José Mauro Pinto, Pérsio Campos Correia de Oliveira Ayres, Ricardo Borghesi, Ronaldo Antonio BMC Gastroenterol Research BACKGROUND: Demonstration of access to the bile duct through Enlarged Papillary Fistulotomy, a method different from conventional fistulotomy. AIMS: Demonstration of the EFP technique with dissection in layers of the papilla for accessing the common bile duct, its efficiency and safety, rescue of cases of failure in cannulation and cases of access failure by EFP in the first attempt, facilitating cannulation in the second attempt. METHODS: Cross-sectional study, with retrospective data collection from 2233 ERCP exams with 528 EFP procedures, analysis of success and complications. RESULTS: 528 patients underwent EFP on the first attempt, with success in 465 cases (88.06%) and 63 failures (11.94%). Of these failures, 33 patients (52.38%) returned for a second EFP attempt, with success in 30 cases (90.9%) and failure in 3 cases (9.1%). Deep bile duct cannulation was achieved in 93.75% of EFP procedures, and cannulation failure occurred in 33 cases (6.25%). CONCLUSION: EFP showed efficiency in CBD cannulation, did not induce post-ERCP pancreatitis, no cases of perforation or false tract, but resulted in higher rates of minor bleeding, rescued cases of access failure by EFP, facilitated the posterior approach on the second attempt, it is safe, effective, low risk and associated with few comorbidities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-023-03013-w. BioMed Central 2023-11-29 /pmc/articles/PMC10687980/ /pubmed/38030984 http://dx.doi.org/10.1186/s12876-023-03013-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gomes, Alexandre
Haidar, Ana Sarah Rafka
Padilha, Giovani Caetano
Bara, Juliana
Nonato, Mariana Sussai
da Silva Rodrigues, José Mauro
Pinto, Pérsio Campos Correia
de Oliveira Ayres, Ricardo
Borghesi, Ronaldo Antonio
Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title_full Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title_fullStr Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title_full_unstemmed Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title_short Enlarged fistulotomy of the papilla as access to the biliary tract during ERCP
title_sort enlarged fistulotomy of the papilla as access to the biliary tract during ercp
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687980/
https://www.ncbi.nlm.nih.gov/pubmed/38030984
http://dx.doi.org/10.1186/s12876-023-03013-w
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