Morphological Characteristics of the Duodenal Papilla and its Association with Complications Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) in a Peruvian Hospital

Quiroga-Purizaca W.G.; Paucar-Aguilar D.R.; Barrientos-Pérez J.A.; Vargas-Blacido D.A. · Revista Colombiana de Gastroenterologia (2022) · DOI: 10.22516/25007440.859

Resumen

Introduction: several risk factors exist for complications post-endoscopic retrograde cholangiopancreatography (ERCP), and the morphology of the duodenal papilla is among those recently studied. Objectives: to evaluate the association between the morphological characteristics of the duodenal papilla and post-ERCP complications in patients seen in the gastroenterology unit of a Peruvian referral hospital. Methods: a prospective and analytical study including 138 patients who underwent ERCP, establishing a relationship between the type of duodenal papilla according to the endoscopic classification proposed by Haraldsson et al. and post-ERCP complications for up to 1 month of follow-up. Results: one hundred thirty-eight patients were included, 93 were females (68.42%), and 45 were males (31.58%), with 51.46 years of mean age. Type 1 was associated with less difficulty in cannulation, with an odds ratio (OR): 0.42 (confidence interval [CI]: 0.20–0.88). Type 4 had a significantly longer cannulation time (6.83 minutes). The post-ERCP ratio for pancreatitis was 2.9%; bleeding, 1.45%, and perforation, 0.72%. The perforation showed a statistically significant association with papilla type (p = 0.009). Type 2 showed higher rates of pancreatitis (9.09%) and post-ERCP perforation (9.09%). Conclusion: the duodenal papilla type is significantly associated with post-ERCP perforation. Type 2 showed higher complication rates.

Instituciones: Universidad Nacional Mayor de San Marcos