Dome vs tapered tip sphincterotomes in endoscopic retrograde cholangiopancreatography: A pilot study on cannulation success and postprocedural pancreatitis

Table 1 Baseline demographic and clinical characteristics of the study population, n (%)

Variables	Dome tip (n = 45)	Tapered tip (n = 45)	P value1
Age, year (median, min-max)	72 (32-91)	71 (32-92)	0.59
Age ≥ 65	30 (66.7)	26 (57.8)
Age < 65	15 (33.3)	19 (42.2)
Sex			0.12
Male	15 (33.3)	19 (42.2)
Female	30 (66.7)	26 (57.8)
BMI	24.06 ± 4.79	24.81 ± 4.03	0.81
BMI ≥ 25 kg/m2	12 (26.7)	21 (46.7)
BMI < 25 kg/m2	33 (73.3)	24 (53.3)
Indications (malignant/benign)			0.4
Malignant
Pancreatic cancer	3 (6.7)	2 (4.4)
Cholangiocarcinoma	5 (11.1)	5 (11.1)
Other cancers	3 (6.7)	0 (0.0)
Benign
Choledocholithiasis	32 (71.1)	34 (75.6)
Benign biliary stricture	2 (4.4)	4 (8.9)

¹P values were calculated using the t-test for continuous variables and χ² test for categorical variables.

BMI: Body mass index.

Table 2 Outcomes of cannulation and procedural metrics

Variables	Dome tip (n = 43)	Tapered tip (n = 42)	P value1
Selective biliary cannulation success rate	32/43	36/42	0.20
Difficult cannulation	14/43	6/42	0.05
More than 5 contacts with the papilla	5	2	0.93
More than 5 minutes spent attempting	11	6	0.08
More than one unintended pancreatic duct cannulation or opacification	3	2	0.62
Time to selective biliary cannulation (seconds)	237.74 ± 252.36	188.7 ± 319.96	0.43
Number of papilla contacts	3.03 ± 2.45	2.24 ± 2.17	0.37
Number of unintentional P duct cannulation	0.47 ± 0.63	0.38 ± 0.58	0.53
Total procedure time (seconds)	971.16 ± 367.13	808 ± 409.57	0.06

¹P values were calculated using the t-test for continuous variables and χ² test for categorical variables.

Table 3 Rescue cannulation techniques

Variables	Dome tip	Tapered tip	P value1
Switching the sphincterotome to either a dome tip or a tapered tip	7	2	0.34
Pancreatic duct guidewire technique	3	3	0.60
Precut sphincterotomy	1	1	0.59
Total	11	6

¹P values were calculated using the t-test for continuous variables and χ² test for categorical variables.

Table 4 Incidence of post-endoscopic retrograde cholangiopancreatography complications, n (%)

Variables	Dome tip (n = 43)	Tapered tip (n = 42)	P value1
Rate of post-ERCP pancreatitis	6 (14.0)	5 (11.9)	0.72
Rate of post-ERCP bleeding	0 (0.0)	0 (0.0)	-
Rate of perforation	0 (0.0)	0 (0.0)	-

¹P values were calculated using the t-test for continuous variables and χ² test for categorical variables.

ERCP: Endoscopic retrograde cholangiopancreatography.

Table 5 Analysis of predictive factors for post-endoscopic retrograde cholangiopancreatography pancreatitis: A univariate and multivariate analysis

Variables	Univariate			Multivariate
	Odds ratio	95%CI	P value1	Odds ratio	95%CI	P value1
Age	0.48	0.13-1.72	0.26
Sex	1.75	0.47-6.49	0.40
BMI	2.09	0.58-7.50	0.26
Malignant/benign	0.95	0.18-4.90	0.95
Dome tip vs tapered tip	1.27	0.36-4.52	0.72
Time to selective biliary cannulation	14.00	2.77-70.86	0.00	9.33	1.31-66.44	0.03
Time to ERCP procedure	6.98	1.41-34.64	0.02	3.23	0.50-20.80	0.22
Number of contrast papilla contact	0.18	0.04-0.74	0.02	1.00	0.14-6.94	1.00
Number of unintentional P duct cannulation	0.43	0.12-1053	0.19
Rescue cannulation	2.68	0.68-10.52	0.16

¹P values were calculated using the t-test for continuous variables and χ² test for categorical variables.

CI: Confidence interval; BMI: Body mass index; ERCP: Endoscopic retrograde cholangiopancreatography.