Year 2018, Volume 2 , Issue 3, Pages 253 - 256 2018-09-01

Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?
Endoskopik retrograd kolanjiyopankreatografide kanülasyon başarısızlığı önlenebilir mi?

Yahya Kemal ÇALIŞKAN [1] , Mustafa Uygar KALAYCI [2]


Aim: Endoscopic retrograde cholangiopancreatography (ERCP) is frequently used in the diagnosis and treatment of hepatic, biliary and pancreatic diseases. Failure during cannulation, however, requires other interventions. The purpose of this work is to create the parameters that can be used to predict failure during ERCP.
Methods: Case control study planned. ERCP procedures between December 2016 and February 2018 were evaluated. Duplicate attempts and causes, cannulation status were recorded and the factors affecting cannulation were examined. Descriptive analyzes were used for statistical evaluation, chi-square test for categorical data and t-test for continuous data. A p value of 0.05 or less was considered statistically significant in the analysis.
Results: A total of 458 ERCP procedures were performed in 288 patients during the study period. 159 of the patients were female, 129 were male, female / male ratio was 1.2, mean age was 59±17.9 and age range was 17-105. When ERCP indications were evaluated, 258 patients (89.6%) were treated due to choledocholithiasis. In the first procedure, selective choledochal cannulation was successful in 257 (89.3%) patients (229 patients with ERCP catheter and 28 patients with assisted methods), and these patients constituted study group. The remaining patients who cannulation was failed included in control group. There were no age and gender differences in the patients who failed cannulation (p: 0.270, 0.256, respectively). In failed cases, the duodenal diverticulum and pancreas head tumor were seen. In the first operation, 264 patients, mainly choledocholithiasis (n: 214), could be diagnosed.
Conclusion: It has been shown that the gender and age of the patient and structural differences such as the duodenal diverticulum do not affect the success of cannulation during ERCP. Upper abdominal operations like Billroth II and Roux-en-Y gastrojejunostomy reduce the success rate of cannulation. It is thought that the correlation between experience level of endoscopist and cannulation success.
Amaç: Endoskopik retrograd kolanjiyopankreatografi (ERCP) sıklıkla hepatik, safra yolları ve pankreatik hastalıkların tanı ve tedavisinde kullanılır. Bununla birlikte, kanülasyon sırasında başarısızlık diğer müdahaleleri gerektirir. Bu çalışmanın amacı, ERCP sırasında başarısızlığı öngörmek için kullanılabilecek parametreleri oluşturmaktır.
Yöntemler: Olgu kontrol çalışması planlandı. Aralık 2016 - Şubat 2018 tarihleri arasında gerçekleştirilen ERCP işlemleri değerlendirildi. Hastalarda gerçekleştirilen mükerrer girişimler ve nedenleri, kanülasyon durumları kayıt edildi ve kanülasyonu etkileyen faktörler incelendi. İstatistik değerlendirmede tanımlayıcı analizler, kategorik veriler için Ki-kare testi ve sürekli veriler için t-testi testi kullanıldı. Analizlerde p değerinin 0,05 ve daha düşük olması istatistiksel olarak anlamlı kabul edildi.
Bulgular: Çalışma döneminde 288 hastaya uygulanan toplam 458 ERCP işlemi uygulandı. Hastaların 159’u kadın, 129’u erkek, kadın/erkek oranı 1,2, yaş ortalaması 59±17,9 ve yaş aralığı 17-105’di. ERCP endikasyonu değerlendirildiğinde 258 (%89,6) hastada koledokolityazis nedeniyle işlemin gerçekleştirildiği görüldü. İlk işlemde 229 hastada ERCP kateteri ile ve 28 hastada yardımcı yöntemler ile olmak üzere 257 (%89,3) hastada selektif koledok kanülasyonu başarılı oldu. 236 hastada 15 dakikadan az süre içinde kanülasyon başarılı oldu. 31 (%10,7) hastada kanülasyon ilk işlemde başarısız oldu. Başarısız olan hastalarda yaş ve cinsiyet açısından fark saptanmadı (sırasıyla p: 0,270, 0,256). Başarısızlık sebebi olarak geçirilmiş mide-duodenum ameliyatları, duodenum içi divertikül, pankreas başı tümörü görüldü. İlk işlemde başlıca koledokolityazis (n:214) olmak üzere 264 hastaya tanı konulabildi.
Sonuç: Hastanın cinsiyeti, yaşı ve duodenal divertikülü gibi yapısal farklılıkları ERCP sırasında kanülasyonun başarısını etkilemediği gösterildi. Billroth II ve Roux-en-Y gastrojejunostomi gibi üst karın ameliyatlarının kanülasyon başarı oranını düşürdüğü görüldü. Endoskopistlerin tecrübe seviyeleri ile kanülasyon başarısı arasında korelasyon olduğu düşünülmektedir.

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Primary Language en
Subjects Surgery
Journal Section Research article
Authors

Author: Yahya Kemal ÇALIŞKAN
Country: Turkey


Author: Mustafa Uygar KALAYCI

Dates

Publication Date : September 1, 2018

Bibtex @research article { josam435834, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2018}, volume = {2}, pages = {253 - 256}, doi = {10.28982/josam.435834}, title = {Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?}, key = {cite}, author = {Çalışkan, Yahya Kemal and Kalaycı, Mustafa Uygar} }
APA Çalışkan, Y , Kalaycı, M . (2018). Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented? . Journal of Surgery and Medicine , 2 (3) , 253-256 . DOI: 10.28982/josam.435834
MLA Çalışkan, Y , Kalaycı, M . "Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?" . Journal of Surgery and Medicine 2 (2018 ): 253-256 <https://jsurgmed.com/en/pub/issue/36726/435834>
Chicago Çalışkan, Y , Kalaycı, M . "Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?". Journal of Surgery and Medicine 2 (2018 ): 253-256
RIS TY - JOUR T1 - Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented? AU - Yahya Kemal Çalışkan , Mustafa Uygar Kalaycı Y1 - 2018 PY - 2018 N1 - doi: 10.28982/josam.435834 DO - 10.28982/josam.435834 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 253 EP - 256 VL - 2 IS - 3 SN - -2602-2079 M3 - doi: 10.28982/josam.435834 UR - https://doi.org/10.28982/josam.435834 Y2 - 2018 ER -
EndNote %0 Journal of Surgery and Medicine Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented? %A Yahya Kemal Çalışkan , Mustafa Uygar Kalaycı %T Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented? %D 2018 %J Journal of Surgery and Medicine %P -2602-2079 %V 2 %N 3 %R doi: 10.28982/josam.435834 %U 10.28982/josam.435834
ISNAD Çalışkan, Yahya Kemal , Kalaycı, Mustafa Uygar . "Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?". Journal of Surgery and Medicine 2 / 3 (September 2018): 253-256 . https://doi.org/10.28982/josam.435834
AMA Çalışkan Y , Kalaycı M . Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?. J Surg Med. 2018; 2(3): 253-256.
Vancouver Çalışkan Y , Kalaycı M . Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?. Journal of Surgery and Medicine. 2018; 2(3): 253-256.
IEEE Y. Çalışkan and M. Kalaycı , "Can failure of choledochal cannulation in endoscopic retrograde cholangiopancreatography be prevented?", Journal of Surgery and Medicine, vol. 2, no. 3, pp. 253-256, Sep. 2018, doi:10.28982/josam.435834