Portillo RDA, Morales PS, Díaz RJD

Language: Spanish
References: 15
Page: 229-234
PDF size: 634.19 Kb.

ABSTRACT

Introduction: biliary cannulation is the most critical step in endoscopic retrograde cholangiopancreatography (ERCP) with success rates varying depending on the technique used. Type 3 papillae pose a higher risk of difficult cannulation. This study evaluated the efficacy and safety of immediate pre-cut in this type of papilla. Material and methods: a case series study was conducted on 50 patients with type 3 papillae who underwent ERCP with immediate pre-cut. Clinical, biochemical, and procedural outcome variables were recorded. Immediate pre-cut was defined as a fistulotomy performed as the first approach before any standard cannulation attempt. Results: the cannulation success rate was 100%. Standard cannulation was achieved within less than one minute in 54% of cases, while 46% experienced difficult cannulation (six minutes). The incidence of post-ERCP pancreatitis was 6%, with no mortality reported. Conclusion: immediate pre-cut in type 3 papillae achieved a 100% cannulation rate, with a low incidence of complications. However, difficult cannulation persisted in nearly half of the cases, suggesting the need for further studies to optimize its application.

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