Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: Importance of the endoscopist’s expertise level

Table 4 Clinical factors associated with post endoscopic retrograde cholangiopancreatography pancreatitis in conventional technique with sphincterotomy and needle-knife fistulotomy group

	Conventional technique with sphincterotomy						NKF
	Total	With PEP	Without PEP	P value		Odd ratio (95%CI)	Total	With PEP	Without PEP	P value		Odd ratio (95%CI)
	n = 375, (%)	n = 25, (%)	n = 350, (%)	Uni-	Multi-		n = 167, (%)	n = 4, (%)	n = 163, (%)	Uni-	Multi-
Age (yr)	68.7 ± 12.4	65.6 ± 12.5	69.0 ± 12.4	0.194	0.126	0.98(0.94-1.01)	65.7 ± 15.3	69.8 ± 11.9	65.6 ± 15.3	0.593	-
Male (%)	205 (54.7)	12 (48.0)	193 (55.1)	0.490			102 (61.1)	2 (50.0)	100 (61.3)	0.648	-
Periampullary diverticulum	120 (32.0)	8 (32.0)	112 (32.0)	0.999			43 (25.7)	1 (25.0)	42 (25.8)	0.973	-
Malignancy	138 (36.8)	9 (36.0)	129 (36.9)	0.932			62 (37.1)	3 (75.0)	59 (36.2)	0.114	0.165	4.74(0.41-54.8)
Benign diseases	237 (63.2)	16 (64.0)	221 (63.1)	-			105 (62.9)	1 (25.0)	104 (63.8)	-	-
Less-experienced endoscopist	228 (60.8)	20 (80.0)	208 (59.4)	0.044a	0.037a	2.94(1.07-8.10)	77 (46.1)	3 (75.0)	74 (45.4)	0.243	0.110	6.40 (0.45-90.6)
Pancreatic duct stent	72 (19.2)	4 (16.0)	68 (19.4)	0.675			0 (0.0)	0 (0.0)	0 (0.0)	-	-
Cannulation time (min)	4.8 ± 3.5	5.3 ± 3.5	4.7 ± 3.5	0.431			4.8 ± 3.2	8.8 ± 1.7	4.7 ± 3.1	0.010a	0.945	0.99 (0.75-1.31)
Total procedure time (min)	17.2 ± 9.2	21.0 ± 8.8	16.9 ± 9.2	0.031a	0.026a	1.04 (1.01-1.08)	15.2 ± 8.2	30.0 ± 9.3	14.8 ± 7.9	0.000a	0.004a	1.14 (1.04-1.25)

^aP < 0.05.

NKF: Needle-knife fistulotomy; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis; CI: Confidence interval.