Background • Periampullary diverticula can make ERCP challenging due to unusual papilla position and distorted anatomy. • Pre-ERCP CT or MRI, may help define anatomy, localize pathology, and identify periampullary diverticula.
were 124 patients who underwent EPS. The mean age was 36 AE 12 years, 75% (nZ93) were males.(Table 1) The common indications were removal of large radiolucent stones in 48 patients; unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 28 patients and pancreatic duct stricture combined with stones in 48 patients. EPS could be successfully completed in 96% (n-120) patients. Complete ductal clearance in a single session was achieved in only 36 patients, while 40 patients required two sessions. All cases of strictures required graded dilation with a mean of 2.5 sessions (maximum 4 sessions). In four patients, stricture did not dilate adequately after 4 sessions and underwent surgery. There were fifteen adverse events of pain requiring admission for more than 24 hours and three procedure related bleeding, all of which were managed conservatively. The patients had an average follow-up of 8 months (6-12 months) and all the patients were pain free. Conclusions: Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a low incidence of complications and a high rate of treatment success.
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