Document Detail

Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation.
MedLine Citation:
PMID:  8979059     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Prior studies evaluating pre-cutting the major papilla to access the bile duct when standard cannulation falls have usually used the needle-knife papillotome. We conducted a prospective study to evaluate the efficacy and safety of an Erlangen-type pre-cut papillotome for pre-cutting. PATIENTS AND METHODS: Three hundred twenty-seven patients (114 men, mean age 67 years) who underwent first-time sphincterotomy at our institution were included. Pre-cutting was performed if free and wire-guided cannulation of the bile duct failed according to an algorithm. RESULTS: Pre-cutting was performed in 123 patients (38%) and selective cannulation was successful in all. Post-ERCP serum pancreatic enzyme levels were more frequently elevated in the pre-cut group (50%) than the non-pre-cut group (27%, p < 0.001); however, there was no difference in the incidence of post-ERCP pancreatitis (pre-cut = 2.7%, 95% CI: 0.66% to 7.6%; non-pre-cut = 1.6%, 95% CI: 0.3% to 4.7%). The incidence of bleeding was similar (pre-cut, 2.4%, non-pre-cut, 3.9%; p > 0.05). CONCLUSION: Pre-cutting the major papilla for biliary access using the Erlangen-type pre-cut papillotome is an effective and reasonably safe procedure when performed by endoscopists with extensive experience in pancreatobiliary endoscopy.
K F Binmoeller; H Seifert; H Gerke; U Seitz; M Portis; N Soehendra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  44     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-03-18     Completed Date:  1997-03-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  689-95     Citation Subset:  IM    
Department of Endoscopic Surgery, University Hospital Hamburg, Germany.
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MeSH Terms
Ampulla of Vater / surgery*
Bile Duct Diseases / surgery
Catheterization / methods
Cholangiopancreatography, Endoscopic Retrograde
Cholelithiasis / surgery
Cholestasis / surgery*
Common Bile Duct Diseases / surgery
Constriction, Pathologic / surgery
Prospective Studies
Sphincterotomy, Endoscopic / instrumentation*,  methods
Surgical Instruments

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