TY - JOUR AB - Endoscopic retrograde cholangiopancreatography (ERCP) is not always successful when difficult biliary cannulation occurs. A second ERCP seems to be a worthwhile option following initial failure cannulation; however, relevant data are limited. Thus, the aim of the present study was to determine the outcomes of repeating ERCP in patients in whom the first biliary cannulation with or without precut sphincterotomy failed. It retrospectively analyzed 4,136 patients who underwent an initial biliary access between June 2016 and September 2020. Data from our databases were analyzed. Efficacy was based on the cannulation rate of the second ERCP and safety was assessed in terms of adverse events. Of 94 patients, 56 (59.6%) underwent a second ERCP and the success rate in biliary cannulation was 83.9% (47 of 56). The median operative time in the second ERCP was shorter than that in the initial procedure (47 vs. 65 min, P<0.001). A total of 5 patients (8.9%) suffered from mild ERCP‑associated complications following the second ERCP. Compared with patients that did not undergo a second ERCP, patients that underwent a second ERCP had a lower 30‑day mortality rate (13.2 vs. 1.8%, P=0.038). In addition, by univariate and multivariate analysis, it was observed that normal preoperative serum bilirubin levels and an interval time of <3 days were correlated with the cannulation failure of a second ERCP (OR=9.211, P=0.019, OR=6.765, P=0.041, respectively). A second ERCP following failure of an initial biliary cannulation appears to be safe and effective. For most clinically stable patients with an unsuccessful initial ERCP, a second ERCP after 2‑4 days may be an optimal strategy. Preoperative normal serum bilirubin levels may be a risk factor that can be used for predicting cannulation failure of a second ERCP procedure. AD - Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China AU - Deng,Xin AU - Liao,Rui AU - Pan,Long AU - Du,Chengyou AU - Wu,Qiao DA - 2022/04/01 DO - 10.3892/etm.2022.11226 IS - 4 JO - Exp Ther Med KW - endoscopic retrograde cholangiopancreatography difficult biliary cannulation needle‑knife predictive factors PY - 2022 SN - 1792-0981 1792-1015 SP - 297 ST - Second endoscopic retrograde cholangiopancreatography after failure of initial biliary cannulation: A single institution retrospective experience T2 - Experimental and Therapeutic Medicine TI - Second endoscopic retrograde cholangiopancreatography after failure of initial biliary cannulation: A single institution retrospective experience UR - https://doi.org/10.3892/etm.2022.11226 VL - 23 ER -