Journal of clinical medicine
Papillary Morphology, Periampullary Diverticulum, and Comorbidity Burden in Relation to Cannulation Outcomes and Procedural Difficulty in ERCP
By Kaya M, Köseoğlu H, Düzenli T and 3 others.
Abstract
Background
Although it has been suggested that papillary morphology and periampullary diverticulum (PAD) may affect the outcomes of endoscopic retrograde cholangiopancreatography (ERCP), the independent effects of these factors have not been clearly established. In this study, we aimed to evaluate the association of papillary morphology and PAD with ERCP success, procedural difficulty, and post-ERCP complications.
Methods
Records of 1046 ERCP procedures performed at a single center were retrospectively reviewed. The primary analysis included 693 patients with native papillae and no prior sphincterotomy. Papilla morphology was available for 381 patients and periampullary diverticulum (PAD) status for 633. Outcomes included cannulation success, difficult cannulation, cannulation time, number of cannulation attempts, post-ERCP complications, and length of hospital stay. Multivariable Firth penalized logistic regression was used to evaluate independent associations with difficult cannulation, overall complications, cannulation failure, and post-ERCP pancreatitis (PEP), adjusting for papilla morphology, PAD status, age, sex, American Society of Anesthesiologists (ASA) physical status class, and Charlson Comorbidity Index (CCI).