{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T16:34:41Z","timestamp":1774715681693,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>A small common bile duct (CBD) diameter has been associated with complications and with a difficult biliary cannulation. Previous studies suggested that this diameter can be predicted during the endoscopic retrograde cholangiopancreatography (ERCP) simply by observing the papillary morphology. Despite this published suggestion there is no study addressing this topic. This study evaluated a possible association between the morphology of the major papilla and the diameter of the terminal CBD (t-CBD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Observational cross-sectional study including consecutive patients with na\u00efve papillae was referred for ERCP in two affiliated university hospitals. The transverse (p-transv) and longitudinal measures (p-long) of the papilla were obtained using a visual method. Papillae were classified into nonprominent, prominent, bulging or other. The t-CBD was measured 1\u2009cm from the papilla using fluoroscopic images in prone\/supine. Measurements were performed by two senior endoscopists and outcomes were evaluated using correlation and linear regression model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We included 245 patients with a median age of 76 years. The median p-transv for each type of papillae was as follows: nonprominent = 6\u2009mm, prominent = 9\u2009mm, bulging = 15\u2009mm and other = 6\u2009mm; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001. The median t-CBD for nonprominent = 7.62\u2009mm, prominent = 8.34\u2009mm, bulging = 8.60\u2009mm and other = 8.52\u2009mm; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.40. The correlation between the transverse and longitudinal measures of papilla and the t-CBD were 0.0092 and 0.0614, respectively. In the regression model, the t-CBD diameter was not explained by papilla\u2019s size or morphology (<jats:italic toggle=\"yes\">R<\/jats:italic>\n                                 <jats:sup>2<\/jats:sup> = 1.70%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.80).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The morphology of the papilla must not be used as a predictor of the diameter of the CBD as there is no correlation between these two items.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/meg.0000000000001623","type":"journal-article","created":{"date-parts":[[2019,12,11]],"date-time":"2019-12-11T09:04:32Z","timestamp":1576055072000},"page":"181-186","source":"Crossref","is-referenced-by-count":4,"title":["Should we use papilla morphology to estimate the size of the terminal common bile duct during endoscopic retrograde cholangiopancreatography?"],"prefix":"10.1097","volume":"32","author":[{"given":"Lu\u00eds","family":"Lopes","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"},{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga"},{"name":"ICVS\/3B\u2019s \u2013 PT Government Associate Laboratory"}]},{"given":"Jorge","family":"Canena","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora"},{"name":"Department of Gastroenterology, Nova Medical School\/Faculty of Medical Sciences, Lisbon"},{"name":"Cintesis \u2013 Center for Health Technology and Services Research, Porto"}]},{"given":"Jo\u00e3o","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"},{"name":"Department of Gastroenterology, Centro Hospitalar Cova da Beira, Covilh\u00e3, Portugal"}]},{"given":"Marta","family":"Moreira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"}]},{"given":"In\u00eas","family":"Costa","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga"}]},{"given":"Jo\u00e3o","family":"Gomes-Fonseca","sequence":"additional","affiliation":[{"name":"ICVS\/3B\u2019s \u2013 PT Government Associate Laboratory"}]},{"given":"Tarc\u00edsio","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"}]},{"given":"Gon\u00e7alo","family":"Alexandrino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora"}]},{"given":"Lu\u00eds","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora"}]},{"given":"David","family":"Horta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora"},{"name":"Department of Gastroenterology, Nova Medical School\/Faculty of Medical Sciences, Lisbon"}]},{"given":"S\u00edlvia","family":"Giestas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"}]},{"given":"Helena","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"}]},{"given":"Jos\u00e9","family":"Ramada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Santa Luzia Hospital - Unidade Local de Sa\u00fade Alto Minho, Viana do Castelo"}]},{"given":"Pietro","family":"Familiari","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Agostino Gemelli University Hospital, Rome, Italy"}]},{"given":"M\u00e1rio","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[{"name":"Cintesis \u2013 Center for Health Technology and Services Research, Porto"},{"name":"Department of Gastroenterology, Portuguese Oncology Institute of Porto, Porto, Portugal"}]}],"member":"276","reference":[{"key":"R1-20230916","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000481688","article-title":"Once upon a time a guideline was used for the evaluation of suspected choledocholithiasis: a fairy tale or a nightmare?","volume":"25","author":"Canena","year":"2018","journal-title":"GE Port J 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