Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPFURUYA, Carlos KiyoshiSAKAI, PauloMARINHO, Fabio Ramalho TavaresOTOCH, Jose PinhataCHENG, SpencerPRUDENCIO, Livia LemesMOURA, Eduardo Guimaraes Hourneaux deARTIFON, Everson Luiz de Almeida2018-07-052018-07-052018WORLD JOURNAL OF GASTROENTEROLOGY, v.24, n.16, p.1803-1811, 20181007-9327https://observatorio.fm.usp.br/handle/OPI/26963AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access. METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire (Group.) and papillary fistulotomy (Group.). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications (pancreatitis, bleeding, perforation) were recorded. RESULTS We included 102 patients (66 females and 36 males, mean age 59.11 +/- 18.7 years). Group. and Group. had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively (P = 0.0002). Twelve patients (23.5%) in Group. had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access (Failure Group). The complication rate was 13.7% (2 perforations and 5 mild pancreatitis) vs 2.0% (1 patient with perforation and pancreatitis) in Groups. and., respectively (P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups.engrestrictedAccessCatheterizationComplicationsEndoscopic retrograde cholangiopancreatographyTherapeutic useCommon bile ductpost-ercp pancreatitisneedle-knife fistulotomycommon bile-ductearly precut sphincterotomyretrograde cholangiopancreatographyrisk-factorsstandardmetaanalysismulticenterpapillotomyarticleCopyright BAISHIDENG PUBLISHING GROUP INC10.3748/wjg.v24.i16.1803Gastroenterology & Hepatology2219-2840