Abstract
We have performed selective bile duct cannulation (SBDC) for naive papilla using an algorithm. Using that algorithm, the cannulation moved from the conventional method to the guide-wire method and pre-cut method, sequentially, if SBDC failed. We evaluated the rate of SBDC and post-procedure pancreatitis (PPP) among 281 patients with choledocholithiasis from February 1st, 2011 to August 31st, 2013. We achieved SBDC under the conventional method in 200 out of 281 patients (71.2%). Among patients who underwent the conventional and guide-wire method, we achieved SBDC in 264 out of 281 patients (94.0%). Eleven out of 65 patients (16.9%), who moved on to the guide-wire method, developed PPP, though, moving on to that method was the risk factor for PPP [Odd's ratio; 4.14]. The final cumulative rate of SBDC and PPP were 98.2% (276/281) and 7.5% (21/281), respectively.
