The secret (GTN) of successful ERCP cannulation: a prospective randomised controlled study.

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2002-08-01

A Ghori, M Hallisey, C Nwokolo, D Loft, I Fraser

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Abstract

Background: A key step for success at endoscopic retrograde cholangio-pancreatography (ERCP) is cannulation of the sphincter of Oddi. This prospective randomised controlled study was conducted to assess the effect of glyceryl trinitrate (GTN) on ease of cannulation.

Method: Two hundred and fifty four patients undergoing ERCP were randomised into two groups, 126 controls and 128 pre-treated with GTN.

Result: There were 29 cannulation failures in the whole group (overall failure rate of 11.4%). Failure was significantly less common in the GTN group, 7.03% (9/128) as compared with 15.8% (20/126) in the control group (p=0.0002). Deep cannulation was desired but not achieved in 45/200 patients (22.5%) Of these, 18.4% (19/103) were in the GTN group versus 26.8% (26/97) in the control group. This pattern of difference applied to both trained and trainee endoscopists. No significant side effects of GTN were noticed.

Conclusion: GTN appears to be safe and effective in improving ERCP success rate. We recommend its routine use.

本刊更多论文

成功的ERCP插管的秘密(GTN):一项前瞻性随机对照研究。

背景:内镜逆行胆管胰管造影(ERCP)成功的关键步骤是Oddi括约肌插管。本前瞻性随机对照研究旨在评估三硝酸甘油(GTN)对插管便利性的影响。方法:254例ERCP患者随机分为对照组126例和GTN预处理组128例。结果:全组插管失败29例，总失败率11.4%。GTN组的失败率明显低于对照组，为7.03%(9/128)，而对照组为15.8% (20/126)(p=0.0002)。200例患者中有45例(22.5%)需要进行深度插管，但没有实现。其中，GTN组为18.4%(19/103)，对照组为26.8%(26/97)。这种差异模式适用于训练有素的内窥镜医师和实习内窥镜医师。未发现GTN有明显的副作用。结论:GTN对提高ERCP成功率安全有效。我们建议常规使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of the Royal College of Surgeons of Edinburgh

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