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Endoscopy 1996; 28(4): 334-339
DOI: 10.1055/s-2007-1005476
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Needle-Knife Sphincterotomy as a Precut Procedure: A Retrospective Evaluation of Efficacy and Complications

W. Bruins Slot1 , M. N. Schoeman1 , J. A. Disario2 , F. Wolters1 , G. N. J. Tytgat1 , K. Huibregtse1
  • 1Dept. of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands;
  • 2Division of Gastroenterology, Hepatology, and Nutrition, Dept. of Internal Medicine, School of Medicine, Medical Center, Salt Lake City, Utah, USA
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Publication History

Publication Date:
17 March 2008 (online)

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Needleknife Precut Sphincterotomy: The Devil is in the IndicationsEndoscopy 1997; 29(09): 888-888
DOI: 10.1055/s-2007-1004329

Abstract

Background and Study Aims: Precut sphincterotomy remains a controversial means of gaining biliary access during endoscopic retrograde cholangiopancreatography (ERCP). This report is a retrospective evaluation of the use of needle-knife sphincterotomy as a precut procedure to achieve biliary access during ERCP.

Patients and Methods: From November 1992 to August 1993, a total of 1071 ERCPs were performed at our institution. During this time, precut sphincterotomy was carried out in 180 patients, with complete follow-up obtained in 178 patients. The follow-up concentrated on the efficacy of the procedure and short-term complications.

Results: Cannulation of the common bile duct was achieved immediately after precut sphincterotomy in 88 % of the patients, and during a second ERCP in an additional 11 % of patients (total success rate 99 %). There were no precut-related deaths. The complication rate of precut sphincterotomy was 21 in 178 (12 %). Complications included bleeding in ten patients (5.5 %), perforation in four patients (3 %), pancreatitis in one patient (0.5 %), and fever of unknown origin in six (3 %) patients. All complications were managed conservatively.

Conclusions: Precut sphincterotomy is a safe and highly effective method of gaining biliary access in patients in whom deep cannulation proves difficult or impossible and biliary access is considered essential.