Abstract
Correlation of the Macroscopic Appearance of the Major Duodenal Papilla on Common Bile Duct Cannulation during Endoscopic Retrograde Cholangiopancreatography: A 2-Year Retrospective, Single Center Study
Leonico Gonzales, MD; Ryge Albert Molina, MD; Dennis Fernandez, MD; Ismael Lapus, MD
Section of Gastroenterology, Cardinal Santos Medical Center
Significance: Endoscopic retrograde cholangiopancreatography (ERCP) is frequently done for managing pancreaticobiliary disorders. One of the most vital concerns with regards to ERCP is its high-risk profile in comparison to other endoscopic techniques. According to the European Society of Gastrointestinal Endoscopy, the anatomy of the papilla, such as its size, morphology, or orientation, and anatomical variants, such as presence of a large diverticulum or surgically altered anatomy, could cause a difficult cannulation. Only limited studies however were done focusing on the effect of the macroscopic appearance of the papilla on biliary cannulation outcomes. A universally accepted language to describe the papilla does not currently exist. This study used the recently published 2021 Viana Classification which has shown substantial interobserver agreement and highly reproducible to use. This classifies papilla as flat (type I), prominent tubular non-pleated (type IIA), prominent tubular pleated (type IIB), prominent bulging (type IIC), intradiverticular (type IIIA), diverticular border (type IIIB) and unclassified (type IV) and was used previously to guide usage of needle knife fistulotomy. The authors of the classification suggested the use of this system for standard techniques and complication risk. This study aims to correlate the macroscopic appearance of the papilla on CBD cannulation along with operator experience and adverse events encountered.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |