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

Authors

DOI:

https://doi.org/10.22516/25007440.859

Keywords:

Endoscopic retrograde cholangiopancreatography, Ampulla of Vater, Adverse effects, Endoscopy

Abstract

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.

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Author Biographies

Wilmer Gustavo Quiroga Purizaca, Hospital Guillermo Almenara Irigoyen

Médico especialista en gastroenterología. Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú.

Diego Ricardo Páucar Aguilar, Hospital Nacional Guillermo Almenara Irigoyen

Médico cirujano. Médico residente en Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú.

Jackeline Amparo Barrientos Pérez, Hospital Nacional Guillermo Almenara Irigoyen

Médico cirujano. Médico residente en gastroenterología en Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú.

Daniel Andrei Vargas Blácido, Hospital Nacional Guillermo Almenara Irigoyen

Médico especialista en gastroenterología. Médico gastroenterólogo en Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú.

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Figura 1. Tipos de papila duodenal(8). Tipo 1: de aspecto “habitual”, sin características distintivas específicas. Tipo 2: plana, con diámetro de 3 mm o menor. Tipo 3: protruida, abombada, con infundíbulo prominente. Tipo 4: entre pliegues o “arrugada”. Adaptado de: Haraldsson et al. United Eur Gastroenterol J. 2017;5(4):504-10. Con imágenes del grupo investigador.

Published

2022-09-16

How to Cite

Quiroga Purizaca, W. G., Páucar Aguilar, D. R., Barrientos Pérez, J. A., & Vargas Blácido, D. A. (2022). Morphological Characteristics of the Duodenal Papilla and its Association with Complications Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) in a Peruvian Hospital. Revista Colombiana De Gastroenterología, 37(3), 296–301. https://doi.org/10.22516/25007440.859

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