Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation

Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Emilio J. De la Morena Madrigal, Isabel Rodríguez García, Ana Belén Galera Ródenas, Elena Pérez Arellano
Formato:	article
Lenguaje:	EN
Publicado:	Georg Thieme Verlag KG 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/994bbd6f98074cc696c957ab93b0b908
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:994bbd6f98074cc696c957ab93b0b908
record_format	dspace
spelling	oai:doaj.org-article:994bbd6f98074cc696c957ab93b0b9082021-11-13T00:00:31ZInitial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation2364-37222196-973610.1055/a-1552-3202https://doaj.org/article/994bbd6f98074cc696c957ab93b0b9082021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1552-3202https://doaj.org/toc/2364-3722https://doaj.org/toc/2196-9736Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor of alternative, simpler techniques that have not been shown to be either safer or more effective. Our goal is to test a device that provides the needle-knife papillotome (NKPT) with traction capability and which can facilitate the learning and execution of NKP. Patients and methods This was a descriptive bicentric observational study of a personal cohort of patients undergoing early NKP to analyse the efficacy and safety of the technique with a “hybrid-tome” (HT) built using the isolated core of a NKPT and a conventional canulotome. Results Over a 4-year period, we performed 43 NKPs with the HT, achieving BC in one or two steps in all cases. The 100 % technical success was matched by a 95 % clinical success rate. We recorded 11 adverse events (23 %): five hemorrhages, four pancreatitis, and two cholangitis. In addition to the objective data, we confirmed that HT facilitates alignment with the duodenal papilla and the execution of pre-cutting, especially if the papilla is intradiverticular or hidden by folds. Conclusions The HT tested seems to help trained endoscopists to perform NKP, especially in some anatomic situations, which can improve compliance with the guidelines recommended for early NKP in patients with DBC.Emilio J. De la Morena MadrigalIsabel Rodríguez GarcíaAna Belén Galera RódenasElena Pérez ArellanoGeorg Thieme Verlag KGarticleDiseases of the digestive system. GastroenterologyRC799-869ENEndoscopy International Open, Vol 09, Iss 11, Pp E1611-E1616 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Emilio J. De la Morena Madrigal Isabel Rodríguez García Ana Belén Galera Ródenas Elena Pérez Arellano Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
description	Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor of alternative, simpler techniques that have not been shown to be either safer or more effective. Our goal is to test a device that provides the needle-knife papillotome (NKPT) with traction capability and which can facilitate the learning and execution of NKP. Patients and methods This was a descriptive bicentric observational study of a personal cohort of patients undergoing early NKP to analyse the efficacy and safety of the technique with a “hybrid-tome” (HT) built using the isolated core of a NKPT and a conventional canulotome. Results Over a 4-year period, we performed 43 NKPs with the HT, achieving BC in one or two steps in all cases. The 100 % technical success was matched by a 95 % clinical success rate. We recorded 11 adverse events (23 %): five hemorrhages, four pancreatitis, and two cholangitis. In addition to the objective data, we confirmed that HT facilitates alignment with the duodenal papilla and the execution of pre-cutting, especially if the papilla is intradiverticular or hidden by folds. Conclusions The HT tested seems to help trained endoscopists to perform NKP, especially in some anatomic situations, which can improve compliance with the guidelines recommended for early NKP in patients with DBC.
format	article
author	Emilio J. De la Morena Madrigal Isabel Rodríguez García Ana Belén Galera Ródenas Elena Pérez Arellano
author_facet	Emilio J. De la Morena Madrigal Isabel Rodríguez García Ana Belén Galera Ródenas Elena Pérez Arellano
author_sort	Emilio J. De la Morena Madrigal
title	Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
title_short	Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
title_full	Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
title_fullStr	Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
title_full_unstemmed	Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
title_sort	initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
publisher	Georg Thieme Verlag KG
publishDate	2021
url	https://doaj.org/article/994bbd6f98074cc696c957ab93b0b908
work_keys_str_mv	AT emiliojdelamorenamadrigal initialexperiencewithahomemadehybridtomeforneedleknifeprecutinpatientswithdifficultbiliarycannulation AT isabelrodriguezgarcia initialexperiencewithahomemadehybridtomeforneedleknifeprecutinpatientswithdifficultbiliarycannulation AT anabelengalerarodenas initialexperiencewithahomemadehybridtomeforneedleknifeprecutinpatientswithdifficultbiliarycannulation AT elenaperezarellano initialexperiencewithahomemadehybridtomeforneedleknifeprecutinpatientswithdifficultbiliarycannulation
_version_	1718430331180154880

Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation

Ejemplares similares