Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography

Table 1 Characteristics and diagnosis of the patients (n = 113)

Characteristics and diagnosis	Number of patients
Mean age (range, yr)	70 (33-90)
Male/Female	63/50
History of pancreatitis	8 (7%)
History of post-ERCP pancreatitis	0%
Normal bilirubin level	67 (59%)
Duodenal diverticulum	32 (28%)
Pancreatic duct stenosis	7 (6%)
Mean procedure time (range, min)	46 (17-98)
Procedure time > 45 min	52 (46%)
Therapeutic ERCP	75 (66%)
Pancreatic duct opacification	100 (100%)
Pancreatic duct stenting	64 (57%)
Biliary sphincterotomy	39 (35%)
Precut	8 (7.1%)
Intraductal ultrasonography	25 (22%)
Biliary stent placement	24 (21%)
Papillary balloon dilatation	2 (1.8%)
Cytology of bile/pancreatic juice	11 (9.7%)
Biopsy of the bile duct/pancreatic duct	10 (8.8%)
Choledocholithiasis	42 (37%)
Cholecystolithiasis	26 (23%)
Cholangiocarcinoma	9 (8.0%)
Pancreatic cancer	8 (7.1%)
Chronic pancreatitis	5 (4.4%)
Intraductal papillary mucinous neoplasm	4 (3.5%)
Ampullary cancer/adenoma	4 (3.5%)

Table 2 Risk factors of post-ERCP pancreatitis (univariate analysis) n (%)

Risk factors	Pancreatitis (+)	Pancreatitis (-)	P	OR (95% CI)
	(n = 14)	(n = 99)
Age (< 50 yr)	2 (14)	3 (3)	0.22	5.3 (0.81-35)
Female gender	8 (57)	42 (42)	0.45	1.8 (0.58-5.6)
History of pancreatitis	0	8 (8)	0.58	-
Normal bilirubin level	12 (86)	55 (56)	0.063	4.8 (1.0-23)
Duodenal diverticulum	3 (21)	29 (29)	0.77	0.66 (0.17-2.5)
Pancreatic duct stenosis	0	7 (7)	0.66	-
Procedure time > 45 min	5 (36)	47 (47)	0.59	0.61 (0.19-2.0)
Therapeutic ERCP	7 (50)	68 (69)	0.28	0.46 (0.15-1.4)
PD opacification	14 (100)	99 (100)	-	-
No PD stenting	11 (79)	38 (38)	0.011	5.9 (1.5-22)
Failure in PD stenting	2 (14)	3 (3)	0.22	5.3 (0.81-35)
Unsuccessful BD cannulation	4 (29)	27 (27)	0.83	1.1 (0.31-3.7)
Biliary sphincterotomy	3 (21)	36 (36)	0.42	0.48 (0.12-1.8)
Precut	2 (14)	6 (6)	0.57	2.6 (0.47-14)
Intraductal ultrasonography	3 (21)	22 (22)	0.78	0.95 (0.24-3.7)
Biliary stent placement	2 (14)	22 (22)	0.74	0.58 (0.12-2.8)
Papillary balloon dilatation	1 (7)	1 (1)	0.58	7.5 (0.44-128)
Cytology of bile/pancreatic juice	1 (7)	10 (10)	0.89	0.68 (0.081-5.8)
Biopsy of the BD/PD	1 (7)	9 (9)	0.79	0.77 (0.090-6.6)
Choledocholithiasis	5 (36)	37 (37)	0.86	0.93 (0.29-3.0)
Cholecystolithiasis	5 (36)	21 (21)	0.39	2.1 (0.62-6.8)
Cholangiocarcinoma	1 (7)	8 (8)	0.68	0.88 (0.10-7.6)
Pancreatic cancer	0	8 (8)	0.58	-
Chronic pancreatitis	0	5 (5)	0.87	-
Intraductal papillary mucinous neoplasm	1 (7)	3 (3)	0.99	2.5 (0.24-25)
Ampullary cancer/adenoma	0	4 (4)	0.99	-

ERCP: Endoscopic retrograde cholangiopancreatography; PD: Pancreatic duct; BD: Bile duct; OR: Odds ratio; CI: Confidence interval.

Table 3 Risk factors of post-ERCP pancreatitis (multivariate analysis)

	P
Age (< 50 yr)	0.9
Female gender	0.97
Normal bilirubin level	0.12
Therapeutic ERCP	0.63
Biliary sphincterotomy	0.81
No PD stenting	0.017
Unsuccessful BD cannulation	0.65
Cholecystolithiasis	0.44

PD: Pancreatic duct; ERCP: Endoscopic retrograde cholangio-pancreato-graphy; BD: Bile duct.