{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:26:30Z","timestamp":1745468790278,"version":"3.40.4"},"reference-count":14,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["GE Port J Gastroenterol"],"abstract":"<jats:p>Introduction: To access the common bile duct in endoscopic retrograde cholangiopancreatography (ERCP), needle-knife fistulotomy (NKF) can be associated with a shorter sphincterotomy compared to standard cannulation. We aimed to compare the success and safety of NKF versus standard cannulation in the treatment of choledocholithiasis. Methods: A cohort of 379 na\u00efve patients with choledocholithiasis who underwent ERCP between 2005 and 2022 was retrospectively analyzed. The patients were divided into two groups: group A (179 consecutive patients) underwent NKF, while group B (180 patients) received standard biliary access and were matched for stone characteristics and ERCP year. Results: Stone removal success rate for group A was significantly lower than that for group B in the initial ERCP (82.0% vs. 92.1%, p = 0.003). In group A, success rates for stone removal were 90.2%, 80%, and 29.4% for stone sizes &lt;10 mm, 10 mm\u201315 mm, and &gt;15 mm, respectively (p &lt; 0.001). In contrast, group B showed success rates of 99.2%, 81.5%, and 71.4% for the same stone size categories (p &lt; 0.001). Pancreatitis occurred in 3.7% of group A and 5.8% of group B patients (p = 0.340). Regression analysis revealed that NKF cannulation, stone size (&gt;10 mm), and having 4 or more stones were associated with lower stone removal success compared to standard cannulation in the initial ERCP (OR 0.34, p = 0.015; stone size 10\u201315 mm: OR 0.20, p &lt; 0.001; stone size &gt;15 mm: OR 0.05, p &lt; 0.001; 4 or more stones: OR 0.4, p = 0.040). Conclusions: The removal of common bile duct stones after NKF access, although safe and effective, is less successful than after a standard cannulation, especially at the baseline ERCP. <\/jats:p>","DOI":"10.1159\/000536398","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T22:04:37Z","timestamp":1708034677000},"page":"401-407","source":"Crossref","is-referenced-by-count":0,"title":["Standard Cannulation versus Fistulotomy for Biliary Access in Endoscopic Retrograde Cholangiopancreatography: Should We Expect the Same Success when Treating Choledocholithiasis?"],"prefix":"10.1159","volume":"31","author":[{"given":"Marta","family":"Moreira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Tarrio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alda Jo\u00e3o","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarc\u00edsio","family":"Ara\u00fajo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Sousa Silva","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Canena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"doi-asserted-by":"publisher","key":"ref1","DOI":"10.1111\/den.13001"},{"doi-asserted-by":"publisher","key":"ref2","DOI":"10.4103\/EUS-D-21-00102"},{"doi-asserted-by":"publisher","key":"ref3","DOI":"10.1016\/j.gie.2014.03.014"},{"doi-asserted-by":"publisher","key":"ref4","DOI":"10.1055\/s-2006-944962"},{"doi-asserted-by":"publisher","key":"ref5","DOI":"10.1055\/s-0042-108641"},{"doi-asserted-by":"publisher","key":"ref6","DOI":"10.1016\/j.gie.2008.09.037"},{"doi-asserted-by":"publisher","key":"ref7","DOI":"10.1055\/s-0029-1243992"},{"doi-asserted-by":"publisher","key":"ref8","DOI":"10.1097\/MD.0000000000012213"},{"doi-asserted-by":"publisher","key":"ref9","DOI":"10.1038\/ajg.2013.217"},{"doi-asserted-by":"publisher","key":"ref10","DOI":"10.1055\/a-1024-3789"},{"doi-asserted-by":"publisher","key":"ref11","DOI":"10.12998\/wjcc.v9.i17.4166"},{"doi-asserted-by":"publisher","key":"ref12","DOI":"10.1038\/s41598-021-96142-9"},{"doi-asserted-by":"publisher","key":"ref13","DOI":"10.17235\/reed.2018.5652\/2018"},{"doi-asserted-by":"publisher","key":"ref14","DOI":"10.1053\/ge.1999.v50.98593"}],"container-title":["GE - Portuguese Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/pjg\/article-pdf\/31\/6\/401\/4308627\/000536398.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/pjg\/article-pdf\/31\/6\/401\/4308627\/000536398.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:07:03Z","timestamp":1745424423000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000536398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":14,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12,3]]},"published-print":{"date-parts":[[2024,12,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000536398","archive":["Portico"],"relation":{},"ISSN":["2341-4545","2387-1954"],"issn-type":[{"type":"print","value":"2341-4545"},{"type":"electronic","value":"2387-1954"}],"subject":[],"published":{"date-parts":[[2024,2,14]]}}}