Oral administration of edible oil before ERCP

Effect on selective biliary cannulation

Mihir S. Wagh, Ahmed Mukhtar, Damien Tan, James L. Watkins, Evan Fogel, Lee McHenry, Gregory A. Coté, Stuart Sherman, Suzette E. Schmidt, Glen Lehman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: A fatty meal before ERCP relaxes the sphincter of Oddi and may facilitate biliary cannulation. Objective: To assess the effect of an oral fatty meal before ERCP on time to and success rate of biliary cannulation. Design: Human clinical study. Setting: Tertiary ERCP center. Patients: Adult patients with intact papilla undergoing ERCP for presumed biliary pathology. Interventions: Patients arriving more than 1 hour before the procedure were given oil by mouth. Patients not receiving oil served as controls. The need for a precut sphincterotomy was considered a failure of initial cannulation. Main Outcome Measurements: Appearance of the papillary orifice, bile flow, cannulation success rate, cannulation and fluoroscopy times. Results: A total of 86 patients received oil (mean age 52.8 years; 40% male), and 103 patients served as controls (mean age 53.3 years; 49% male). The papillary orifice was open in 52 of 86 (61%) and 38 of 103 (37%) patients in the oil and control groups, respectively (P =.002). Bile flow was seen in 59 of 86 (68%) and 50 of 103 (49%) patients, respectively (P =.009). The overall initial biliary cannulation success rate was 80 of 86 (93%) and 97 of 103 (94%), respectively (P =.77). There was no difference in cannulation success rates, cannulation, and fluoroscopy times for fellows or faculty endoscopists in each group. No pulmonary aspiration was seen in either group. Limitations: Unblinded study. Conclusions: The biliary orifice appeared more open and bile flow was seen in more patients receiving oil, but there was no difference in successful biliary cannulation rates and cannulation and fluoroscopy times in the 2 groups.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalGastrointestinal Endoscopy
Volume77
Issue number1
DOIs
StatePublished - Jan 2013

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Endoscopic Retrograde Cholangiopancreatography
Catheterization
Oral Administration
Oils
Fluoroscopy
Bile
Meals
Sphincter of Oddi
Mouth
Pathology
Lung
Control Groups

Keywords

  • CCK
  • cholecystokinin
  • SO
  • sphincter of Oddi

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Oral administration of edible oil before ERCP : Effect on selective biliary cannulation. / Wagh, Mihir S.; Mukhtar, Ahmed; Tan, Damien; Watkins, James L.; Fogel, Evan; McHenry, Lee; Coté, Gregory A.; Sherman, Stuart; Schmidt, Suzette E.; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 77, No. 1, 01.2013, p. 55-61.

Research output: Contribution to journalArticle

Wagh, Mihir S. ; Mukhtar, Ahmed ; Tan, Damien ; Watkins, James L. ; Fogel, Evan ; McHenry, Lee ; Coté, Gregory A. ; Sherman, Stuart ; Schmidt, Suzette E. ; Lehman, Glen. / Oral administration of edible oil before ERCP : Effect on selective biliary cannulation. In: Gastrointestinal Endoscopy. 2013 ; Vol. 77, No. 1. pp. 55-61.
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abstract = "Background: A fatty meal before ERCP relaxes the sphincter of Oddi and may facilitate biliary cannulation. Objective: To assess the effect of an oral fatty meal before ERCP on time to and success rate of biliary cannulation. Design: Human clinical study. Setting: Tertiary ERCP center. Patients: Adult patients with intact papilla undergoing ERCP for presumed biliary pathology. Interventions: Patients arriving more than 1 hour before the procedure were given oil by mouth. Patients not receiving oil served as controls. The need for a precut sphincterotomy was considered a failure of initial cannulation. Main Outcome Measurements: Appearance of the papillary orifice, bile flow, cannulation success rate, cannulation and fluoroscopy times. Results: A total of 86 patients received oil (mean age 52.8 years; 40{\%} male), and 103 patients served as controls (mean age 53.3 years; 49{\%} male). The papillary orifice was open in 52 of 86 (61{\%}) and 38 of 103 (37{\%}) patients in the oil and control groups, respectively (P =.002). Bile flow was seen in 59 of 86 (68{\%}) and 50 of 103 (49{\%}) patients, respectively (P =.009). The overall initial biliary cannulation success rate was 80 of 86 (93{\%}) and 97 of 103 (94{\%}), respectively (P =.77). There was no difference in cannulation success rates, cannulation, and fluoroscopy times for fellows or faculty endoscopists in each group. No pulmonary aspiration was seen in either group. Limitations: Unblinded study. Conclusions: The biliary orifice appeared more open and bile flow was seen in more patients receiving oil, but there was no difference in successful biliary cannulation rates and cannulation and fluoroscopy times in the 2 groups.",
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AU - Wagh, Mihir S.

AU - Mukhtar, Ahmed

AU - Tan, Damien

AU - Watkins, James L.

AU - Fogel, Evan

AU - McHenry, Lee

AU - Coté, Gregory A.

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AB - Background: A fatty meal before ERCP relaxes the sphincter of Oddi and may facilitate biliary cannulation. Objective: To assess the effect of an oral fatty meal before ERCP on time to and success rate of biliary cannulation. Design: Human clinical study. Setting: Tertiary ERCP center. Patients: Adult patients with intact papilla undergoing ERCP for presumed biliary pathology. Interventions: Patients arriving more than 1 hour before the procedure were given oil by mouth. Patients not receiving oil served as controls. The need for a precut sphincterotomy was considered a failure of initial cannulation. Main Outcome Measurements: Appearance of the papillary orifice, bile flow, cannulation success rate, cannulation and fluoroscopy times. Results: A total of 86 patients received oil (mean age 52.8 years; 40% male), and 103 patients served as controls (mean age 53.3 years; 49% male). The papillary orifice was open in 52 of 86 (61%) and 38 of 103 (37%) patients in the oil and control groups, respectively (P =.002). Bile flow was seen in 59 of 86 (68%) and 50 of 103 (49%) patients, respectively (P =.009). The overall initial biliary cannulation success rate was 80 of 86 (93%) and 97 of 103 (94%), respectively (P =.77). There was no difference in cannulation success rates, cannulation, and fluoroscopy times for fellows or faculty endoscopists in each group. No pulmonary aspiration was seen in either group. Limitations: Unblinded study. Conclusions: The biliary orifice appeared more open and bile flow was seen in more patients receiving oil, but there was no difference in successful biliary cannulation rates and cannulation and fluoroscopy times in the 2 groups.

KW - CCK

KW - cholecystokinin

KW - SO

KW - sphincter of Oddi

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