Brief Article
Copyright ©2011 Baishideng Publishing Group Co.
World J Gastroenterol. Dec 7, 2011; 17(45): 4993-4998
Published online Dec 7, 2011. doi: 10.3748/wjg.v17.i45.4993
Table 1 Schutz grade for endoscopic retrograde cholangiopancreatography degree of difficulty for biliary procedures[11]
Biliary procedures
Grade 1Diagnostic cholangiogram
Biliary cytology
Standard sphincterotomy ± removal of stones < 10 mm
Stricture dilatation/stent for extra-hepatic stricture
or bile leak
Grade 2Diagnostic cholangiogram with
Billroth II anatomy
Removal of CBD stones > 10 mm
Stricture dilatation/stent for hilar tumors or benign intrahepatic strictures
Grade 3SOD manometry
Any therapy with Billroth II anatomy
Removal of intrahepatic stones or any stones with lithotripsy
Table 2 Clinical indication for procedures n (%)
IndicationTertiary referral cohort (n = 51)Naïve papilla cohort (n = 940)P value
Choledocholithiasis23 (45.1)446 (47.4)0.78
Pancreatic malignancy9 (17.7)194 (20.6)0.72
Benign biliary stricture/PSC6 (11.8)41 (4.4)0.03
Bile leak5 (9.8)59 (6.3)0.37
Cholangitis4 (7.8)57 (6.1)0.48
Other (acute pancreatitis, suspected sphincter dysfunction)4 (7.8)143 (15.2)0.22
Table 3 Comparison of referred failed biliary cannulation ERCP and naïve papilla patients
Non-referred naive papillaPrevious failed biliary cannulationP value
Mean age (yr)62.5 (40-87)59.9 (18-96)NS
Sex (female:male)69:3161:39NS
Cannulation attempts3.2 (1-14)2.96 (1-8)NS
Time to cannulation4.2 min (0.08-41)4.4 min (0.8-13.5)NS
Cannulation success98%100%1.00
NKS rate12.7%27.4%0.017
Other ERCP complicationBleeding 0.5%Nil
Perforation 0.2%