<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452024000600025</article-id>
<article-id pub-id-type="doi">10.1159/000536398</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Standard Cannulation versus Fistulotomy for Biliary Access in Endoscopic Retrograde Cholangiopancreatography: Should We Expect the Same Success when Treating Choledocholithiasis?]]></article-title>
<article-title xml:lang="pt"><![CDATA[Canulação convencional versus &#64257;stulotomia para acesso à via biliar em CPRE: devemos esperar o mesmo sucesso no tratamento da coledocolitíase?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tarrio]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Andrade]]></surname>
<given-names><![CDATA[Alda João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araújo]]></surname>
<given-names><![CDATA[Tarcísio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[João Sousa Silva]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canena]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[Luís]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A7"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Santa Luzia Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Viana do Castelo ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital CUF Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Viseu/Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Professor Doutor Fernando Fonseca Hospital Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Amadora ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Cintesis - Center for Health Technology and Services Research  ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Nova Medical School Faculty of Medical Sciences Department of Gastroenterology]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,University of Minho School of Medicine Life and Health Sciences Research Institute (ICVS)]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,ICVS/3B&#8217;s - PT Government Associate Laboratory  ]]></institution>
<addr-line><![CDATA[Braga/Guimarães ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>31</volume>
<numero>6</numero>
<fpage>25</fpage>
<lpage>31</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452024000600025&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452024000600025&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452024000600025&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  To access the common bile duct in endoscopic retrograde cholangiopancreatography (ERCP), needle-knife &#64257;stulotomy (NKF) can be associated with a shorter sphincterotomy compared to standard cannulation. We aimed to compare the success and safety of NKF versus standard cannulation in the treatment of choledocholithiasis.  Methods:  A cohort of 379 naïve patients with choledocholithiasis who underwent ERCP between 2005 and 2022 was retrospectively analyzed. The patients were divided into two groups: group A (179 consecutive patients) underwent NKF, while group B (180 patients) received standard biliary access and were matched for stone characteristics and ERCP year.  Results:  Stone removal success rate for group A was signi&#64257;cantly lower than that for group B in the initial ERCP (82.0% vs. 92.1%, p = 0.003). In group A, success rates for stone removal were 90.2%, 80%, and 29.4% for stone sizes &lt;10 mm, 10 mm-15 mm, and &gt;15 mm, respectively (p &lt; 0.001). In contrast, group B showed success rates of 99.2%, 81.5%, and 71.4% for the same stone size categories (p &lt; 0.001). Pancreatitis occurred in 3.7% of group A and 5.8% of group B patients (p = 0.340). Regression analysis revealed that NKF cannulation, stone size (&gt;10 mm), and having 4 or more stones were associated with lower stone removal success compared to standard cannulation in the initial ERCP (OR 0.34, p = 0.015; stone size 10-15 mm: OR 0.20, p &lt; 0.001; stone size &gt;15 mm: OR 0.05, p &lt; 0.001; 4 or more stones: OR 0.4, p = 0.040).  Conclusions:  The removal of common bile duct stones after NKF access, although safe and effective, is less successful than after a standard can-nulation, especially at the baseline ERCP.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Para aceder à via biliar na CPRE, a &#64257;stulotomia com needle-knife (NKF) pode estar associada a uma es&#64257;ncterotomia mais curta em comparação com a canulação convencional. O nosso objetivo é comparar o sucesso e a segurança da NKF versus a canulação convencional no tratamento da coledocolitíase.  Métodos:  Foi analisada retrospetivamente uma coorte de 379 pacientes naïve com coledocolitíase con&#64257;rmada submetidos a CPRE entre 2005 e 2022. Os pacientes foram divididos em dois grupos: Grupo A (179 pacientes consecutivos) submetidos a NKF, enquanto no Grupo B (180 pacientes) o acesso biliar foi realizado por técnicas convencionais, sendo emparelhados quanto ao número e tamanho dos cálculos e quanto ao ano em que a CPRE foi realizada.  Resultados:  A taxa de sucesso na remoção de cálculos para o Grupo A foi signi&#64257;cativamente inferior à do Grupo B na CPRE inicial (82.0% vs. 92.1%, p = 0.003). No Grupo A, as taxas de sucesso na remoção de cálculos foram de 90.2%, 80% e 29.4% para tamanhos de pedra &lt;10 mm,10mm-15 mm e &gt; 15 mm, respetivamente (p &lt; 0.001). Por outro lado, o Grupo B apresentou taxas de sucesso de 99.2%, 81.5% e 71.4%para as mesmas categorias de tamanho dos cálculos (p &lt; 0.001). A pancreatite ocorreu em 3.7% dos pacientes do Grupo A e 5.8% dos pacientes do Grupo B (p = 0.340). A análise de regressão revelou que no grupo A, o tamanho dos cálculos (&gt;10 mm) e ter 4 ou mais cálculos estavam associados a uma menor taxa de sucesso em comparação com a canulação convencional na CPRE inicial (OR 0.34, p = 0.015; cálculo com 10-15mm: OR 0.20, p &lt; 0.001; cálculo com &gt;15 mm: OR 0.05, p &lt; 0.001; 4 ou mais cálculos: OR 0.4, p = 0.040).  Conclusões:  O tratamento da coledocolitíase por CPRE após acesso por NKF, embora segura e e&#64257;caz, é menos bem-sucedida do que após canulação convencional, especialmente na CPRE inicial.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Choledocholithiasis]]></kwd>
<kwd lng="en"><![CDATA[Endoscopic retrograde cholangiopancreatography]]></kwd>
<kwd lng="en"><![CDATA[Catheterization]]></kwd>
<kwd lng="en"><![CDATA[Needle-knife &#64257;stulotomy]]></kwd>
<kwd lng="en"><![CDATA[Precut techniques]]></kwd>
<kwd lng="pt"><![CDATA[Coledocolitíase]]></kwd>
<kwd lng="pt"><![CDATA[Colangiopancreatogra&#64257;a retrógrada endoscópica]]></kwd>
<kwd lng="pt"><![CDATA[Cateterização]]></kwd>
<kwd lng="pt"><![CDATA[Fistulotomia com needle-knife]]></kwd>
<kwd lng="pt"><![CDATA[Técnicas de pré-corte]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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