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News

Rendezvous cannulation technique reduces post-ERCP pancreatitis

A nationwide study in this month's American Journal of Gastroenterology finds that rendezvous cannulation technique reduces post-ERCP pancreatitis.

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Dr Fredrik Swahn and colleagues investigated if intraoperative rendezvous cannulation reduces the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis because there is no universal consensus on the optimal treatment of common bile duct stones.

The research team performed a nationwide case–control study, nested within the cohort of post-endoscopic retrograde cholangiopancreatography procedures reported to the Swedish Registry for Gallstone Surgery and post-endoscopic retrograde cholangiopancreatography, between 2007 and 2009.

The researchers collected data prospectively from a web-based registry of post-endoscopic retrograde cholangiopancreatography procedures that includes variables such as patient characteristics, indication, cannulation technique, diagnostic findings, therapeutic measures, and complications.

The primary outcome was pancreatitis.

The research team reported that the registry included 12,718 post-endoscopic retrograde cholangiopancreatography procedures performed on patients without a history of previous post-endoscopic retrograde cholangiopancreatography.

The rendezvous technique reduced the risk of pancreatitis by 4% to 2%
American Jorunal of Gastroenterology

The risk of pancreatitis when using the rendezvous technique compared with those who were cannulated by conventional means was reduced from 4% to 2%.

The doctors noted that although a significant reduction there are overall relatively few cases with pancreatitis and the calculated numbers needed to treat to avoid one case of PEP is as high as 71.

Other factors associated with increased risk of pancreatitis were young age, prolonged procedure time, and elective post-endoscopic retrograde cholangiopancreatography.

Dr Swahn's team commented "Rendezvous bile duct cannulation during post-endoscopic retrograde cholangiopancreatography reduces the risk of pancreatitis from 4% to 2% compared with conventional biliary cannulation."

Am J Gastroenterol 2013; 108: 552–559
24 April 2013

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