Prect papillotomy using needle knife fashioned from discarded standard papillotomes

Pai, Ganesh C (2000) Prect papillotomy using needle knife fashioned from discarded standard papillotomes. Indian J Gastroenterol., 19 (3). pp. 116-118.

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Abstract

AIM: To evaluate the results of precut papillotomy using needle-knife papillotomes fashioned from discarded standard sphincterotomes.METHODS: Case records of 50 patients undergoing precut papillotomy for access to either common bile duct or pancreatic duct during endoscopic retrograde cholangiopancreatography were reviewed. Precut was performed using needle-knife papillotomes fashioned from standard pull-type sphicterotomes that were discarded because of broken cutting wires. A diagnostic procedure was planned in all 50 patients (bile duct = 39, pancreatic duct = 9, both ducts = 2) and therapeutic procedure in 36 patients (bile duct = 31, pancreatic duct = 5).RESULTS: Of the 47 patients who needed precut prior to diagnostic ERCP, 44 (93.6%) underwent successful cannulation of the duct of choice. Therapeutic procedures were planned in 36 patients; these were successful in 24 (67%; bile duct = 22, pancreatic duct = 2). The complications included cholangitis in 8 patients (16%) and pancreatitis in 2 (4%). None had bleeding or perforation.CONCLUSIONS: Precut needle-knife papillotomes fashioned from discarded standard sphincterotomes can be used effectively and can help in cost containment in endoscopic retrograde cholangiopancreatography

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