Transnasal endoscopic retrograde chalangiopancreatography using an ultrathin endoscope： A prospective comparison with a routine oral procedure

AIM： To investigate if transnasal endoscopic retrograde cholangiopancreatography （n-ERCP） using an ultrathin forward-viewing scope may overcome the disadvantages of conventional oral ERCP （o-ERCP） related to the largecaliber side-viewing duodenoscope. METHODS： The study involved 50 patients in whom...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2008-03, Vol.14 (10), p.1514-1520
Main Authors: Mori, Akihiro, Ohashi, Noritsugu, Maruyama, Takako, Tatebe, Hideharu, Sakai, Katsuhisa, Shibuya, Takashi, Inoue, Hiroshi, Takegoshi, Shoudou, Okuno, Masataka
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Pressure - physiology
Catheterization
Cholangiopancreatography, Endoscopic Retrograde - instrumentation
Cholangiopancreatography, Endoscopic Retrograde - methods
Clinical Research
Digestive System Diseases - blood
Digestive System Diseases - diagnosis
Digestive System Diseases - physiopathology
Endoscopes, Gastrointestinal - adverse effects
Female
Humans
Hyperamylasemia - etiology
Hypnotics and Sedatives - therapeutic use
Incidence
Male
Middle Aged
Prospective Studies
内窥镜检查法
心血管压力
鼻检查
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Summary:AIM： To investigate if transnasal endoscopic retrograde cholangiopancreatography （n-ERCP） using an ultrathin forward-viewing scope may overcome the disadvantages of conventional oral ERCP （o-ERCP） related to the largecaliber side-viewing duodenoscope. METHODS： The study involved 50 patients in whom 25 cases each were assigned to the o-ERCP and n-ERCP groups. We compared the requirements of esophagogastroduodenoscopy （EGD） prior to ERCP, rates and times required for successful cannulation into the pancreatobiliary ducts, incidence of post-procedure hyperamylasemia, cardiovascular parameters during the procedure, the dose of a sedative drug, and successful rates of endoscopic naso-biliary drainage （ENBD）. RESULTS： Screening gastrointestinal observations were easily performed by the forward-viewing scope and thus no prior EGD was required in the n-ERCP group. There was no significant difference in the rates or times for cannulation, or incidence of hyperamylasemia between the groups. However, the cannulation was relatively difficult in n-ERCP when the scope appeared U-shape under fluoroscopy. Increments of blood pressure and the amount of a sedative drug were significantly lower in the n-ERCP group. ENBD was successfully performed succeeding to the n-ERCP in which mouth-to-nose transfer of the drainage tube was not required. CONCLUSION： n-ERCP is likely a well-tolerable methodwith less cardiovascular stress and no need of prior EGD or mouth-to-nose transfer of the ENBD tube. However, a deliberate application is needed since its performance is difficult in some cases and is not feasible for some endoscopic treatments such as stenting.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.14.1514