A113 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH SURGICALLY ALTERED ANATOMY IN A CANADIAN TERTIARY REFERRAL CENTRE
Notice bibliographique
Résumé
Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) has become a mainstay of diagnosis and treatment of pancreatobiliary conditions. Surgically altered anatomy presents unique challenges in the procedure, necessitating creative solutions such as different types of endoscopes and tools. Distinct from regular anatomy, forward viewing scopes are often required for successful cannulation and therapy of the pancreaticobiliary system. To our knowledge, there is limited data on the practice of ERCP in altered anatomy in Canada. Aims Our aim is to present outcomes from a large series of patients with surgically altered anatomy who underwent ERCP at a large Canadian referral centre. Methods All ERCP procedures at a tertiary referral centre in Vancouver, Canada from Oct 2020 to Oct 2021 were reviewed retrospectively. Inclusion criteria required surgically altered anatomy and attempted ERCP. Liver transplant patients with duct-to-duct anastomosis were not included in the series. Patients with incomplete procedure documentation were excluded. Demographic, procedural and outcome data were collected. Results are presented descriptively and as median + IQR for quantitative data. Procedural success was defined as cannulation and performance of a cholangiogram and/or pancreatogram Results A total of 34 procedures met the inclusion criteria during the study period. Twenty-four procedures were on male patients (71%). Nineteen patients (56%) had had previous ERCP. Sixteen patients (47%) had choledocholithasis as the indication for the procedure, 9 patients (26%) had cholangitis and 5 patients (15%) had concerns of neoplasia. Some patients had multiple indications. Seventeen patients (50%) had roux-en-Y anatomy, 8 patients (24%) were post Whipple’s and 6 patients (18%) had Billroth II type anatomy. Other altered anatomy included duodenal switch, and post gastrojejunostomy bypass. The most commonly used endoscope was the adult or pediatric colonoscope (74% of cases). Single balloon enteroscope was used in 5 cases (15%). Overall success rate was 74%. The breakdown of success rate by anatomy is shown in Table 1. One (3%) complication was noted in the form of mild cholangitis, requiring only outpatient antibiotics. Conclusions Experience in ERCP in patients with altered anatomy is becoming more pertinent in tertiary care. Cannulation and therapy is more difficult in this cohort, but still successful in the majority of cases. Adverse events remain uncommon. Knowledge of forward viewing ERCP techniques is critical in surgically altered anatomy. Future studies will aim to expand the retrospective cohort for more quantitative analysis. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,005 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».