Analysis of the influencing factors of selective intubation difficulties in endoscopic retrograde cholangio-pancreatography

ObjectiveTo analyze the influencing factors of selective intubation difficulties in endoscopic retrograde cholangio-pancreatography(ERCP).

MethodsA total of 345 patients treated with ERCP were investigated, and 40 cases with selective intubation difficulties and other 305 cases were divided into the observation group and control group, respectively.The data of diverticulum distribution, ERCP indications, age and gender between two groups were analyzed using the single factor method, and the differences of which with statistical significance were analyzed using logistic regression method.The independent risk factors of ERCP selective intubation difficulties were investigated.

ResultsAmong 345 patients with ERCP, 40 patients with selective intubation difficulties were identified, and the intubation difficulty rate of which was 11.59%.The differences of the gender, age, emergency ERCP and ERCP were not statistically significant between two groups(P>0.05), and the differences of the distribution of diverticulum, loose and long duodenal papilla, common bile duct bending angle, biliopancreatic duct confluence, nipple shape and stenosis of the lower segment of common bile duct were statistically significant between two groups(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the loose and long duodenal papilla(OR=3.126), common bile duct bending angle(OR=2.811), internal nipple of diverticula(OR=2.703) and asymmetric diverticula at the center of the nipple(OR=2.033) were the independent risk factors of ERCP selective intubation difficulties.

ConclusionsThe incidence rate of ERCP selective intubation difficulties is high, and the loose and long duodenal papilla, diverticulum distribution and common bile duct angle can affect the success rate of intubation.