Efficacy and safety of therapeutic ERCP in patients with ectopic papilla of Vater

Abstract

It remains challenging for endoscopists to manage pancreaticobiliary diseases in patients with ectopic papilla of Vater by endoscopic retrograde cholangiopancreatography (ERCP). The present study sought to evaluate the efficacy and safety of ERCP for this issue. Consecutive patients with ectopic papilla of Vater who underwent initial ERCP due to pancreaticobiliary diseases were retrospectively analyzed. One hundred seven patients with ectopic papilla of Vater were included. The success rate of cannulation was 83.2%. Endoscopic sphincterotomy, endoscopic papillary balloon dilation, and mechanical lithotripsy were performed in 12 (11.2%), 25 (23.4%), and 1 (0.9%) patients, respectively. The technical success rate was 83.2%; of these, endoscopic nasobiliary drainage, endoscopic retrograde biliary drainage, endoscopic retrograde pancreatic drainage, and stone extraction was conducted in 61 (57.0%), 17 (15.9%), 5 (4.7%), and 45 (42.1%) patients, respectively. Bile duct stone size ≥1 cm, number ≥2, and duodenum stenosis were risk factors for stone extraction inability. Adverse events occurred in 20 (18.7%) patients, including post-ERCP pancreatitis (3.7%), hyperamylasemia (12.1%), and infection of biliary tract (2.8%); all of the adverse events were mild and alleviated by conventional therapies. ERCP is an appropriate choice for pancreaticobiliary diseases in patients with ectopic papilla of Vater due to its high efficacy and safety. Bile duct stone size ≥1 cm, number ≥2, and duodenum stenosis increase difficulties for stone extraction.

Outcomes of laparoscopic common bile duct exploration (LCBDE) after failed endoscopic retrograde cholangiopancreatography versus primary LCBDE for managing cholecystocholedocholithiasis

“…Hong et al. 12 recently reported that the success rate of cannulation for 107 patients with an ectopic papilla of Vater was 83.2%. They reported that the ectopic opening was so obscure that it may have increased the difficulty of cannulation.…”

“…They reported that the ectopic opening was so obscure that it may have increased the difficulty of cannulation. 12 Sfarti et al. 13 reported that a periampullary diverticulum can increase the rate of difficult or failed cannulation.…”

“…In the present study, the reasons for failed cannulation included an abnormal position of the AoV (6/31), a periampullary diverticulum (5/31), and previous Billroth II gastrectomy (3/31). Hong et al 12 recently reported that the success rate of cannulation for 107 patients with an ectopic papilla of Vater was 83.2%. They reported that the ectopic opening was so obscure that it may have increased the difficulty of cannulation.…”

“…They reported that the ectopic opening was so obscure that it may have increased the difficulty of cannulation. 12 Sfarti et al 13 reported that a periampullary diverticulum can increase the rate of difficult or failed cannulation. Li et al 14 reported that the success rate of duodenal ampullary access and selective biliary cannulation was 84.1% (191/227) and 92.1% (176/191), respectively, in patients with Billroth II anatomy.…”

Diagnostic Value of Endoscopic Retrograde Cholangiopancreatography and Therapeutic Value of Endoscopic Sphincterotomy in Dogs With Suspected Hepatobiliary Disorders

“…Ultrasonography (US) is the most commonly used non-invasive imaging modality in the evaluation of the hepatobiliary system and the exocrine pancreas in dogs, offering high sensitivity but often lacking speci city, especially in patients with biliary and pancreatic ductal problems [4]. Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be an applicable, direct technique for evaluating hepatobiliary and pancreatic disorders both in human and veterinary medicine [5,6,7,8,9,10]. It is a minimally invasive technique, which combines endoscopy and uoroscopy to image the biliary system (endoscopic retrograde cholangiography, ERC) and pancreatic duct (endoscopic retrograde pancreatography, ERP).…”