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A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study

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タイトル: A multicenter, prospective, randomized study of selective bile duct cannulation performed by multiple endoscopists: the BIDMEN study
著者: Kawakami, Hiroshi 著作を一覧する
Maguchi, Hiroyuki 著作を一覧する
Mukai, Tsuyoshi 著作を一覧する
Hayashi, Tsuyoshi 著作を一覧する
Sasaki, Tamito 著作を一覧する
Isayama, Hiroyuki 著作を一覧する
Nakai, Yousuke 著作を一覧する
Yasuda, Ichiro 著作を一覧する
Irisawa, Atsushi 著作を一覧する
Niido, Teitetsu 著作を一覧する
Okabe, Yoshinobu 著作を一覧する
Ryozawa, Shomei 著作を一覧する
Itoi, Takao 著作を一覧する
Hanada, Keiji 著作を一覧する
Kikuyama, Masataka 著作を一覧する
Arisaka, Yoshifumi 著作を一覧する
Kikuchi, Shogo 著作を一覧する
発行日: 2012年 2月
出版者: Mosby
誌名: Gastrointestinal Endoscopy
巻: 75
号: 2
開始ページ: 362
終了ページ: 372
出版社 DOI: 10.1016/j.gie.2011.10.012
抄録: Background: Wire-guided cannulation (WGC) with a sphincterotome for selective bile duct cannulation (SBDC) has been reported to have a higher success rate and lower incidence of post-ERCP pancreatitis (PEP) than conventional methods in some randomized controlled trials (RCTs) that were both single-center and limited to only a few endoscopists. Objective: To estimate the difference in SBDC according to the method and catheter used in a multicenter and multi-endoscopist study. Design: A prospective multicenter RCT with a 2-by-2 factorial design. Setting: Fifteen referral endoscopy units. Patients: In total, 400 consecutive patients with naïve papilla who were candidates for ERCP were enrolled and randomized. Interventions: Patients were assigned to 4 groups according to combined catheter (sphincterotome (S) or catheter (C)) and method (with/without guidewire (GW)). Main Outcome Measurements: Success rate of SBDC in 10 min, time for SBDC, fluoroscopic time and incidence of complications. Results: There was no significant difference in SBDC success rate between with- and without-GW, between C and S, or between the 4 groups (C+GW, C, S+GW, S). WGC had a tendency to significantly shorten cannulation and fluoroscopy times only in approximately 70% of patients in this study in whom SBDC was achieved in 10 min or less (P = 0.036 and 0.00004, respectively). All 4 groups resulted in similar outcomes in PEP (4%, 5.9%, 2%, and 2.1%, respectively). Limitations: Non double-blind study. Conclusions: WGC appears to significantly shorten cannulation and fluoroscopic times. However, neither the method nor type of catheter used resulted in significant differences in either SBDC success rate or incidence of PEP in this RCT.
資料タイプ: article (author version)
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 河上 洋


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