Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation

Binmoeller, Kenneth F.; Seifert, H.; Gerke, Henning; Seitz, Uwe; Portis, Mary; Soehendra, Nib

doi:10.1016/s0016-5107(96)70053-6

Cited by 107 publications

(82 citation statements)

References 22 publications

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“…Precutting (transpancreatic pre-cut, needle-knife pre-cut, needle-knife fistulotomy, and needle-knife pre-cut over pancreatic stent) is the most popular technique when standard cannulation fails. In the search for an alternative technique when standard cannulation fails, fistulotomy above the papillary orifice has been considered in some studies [1][2][3][8][9][10] . In our study, we demonstrated that the starting point of the fistulotomy on the papilla (distal third, midportion or proximal third) and the length of the incision varied depending on the disorder being treated (bile duct stones, strictures, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…This discrepancy probably relates to the endoscopist's level of expertise and the number of failed attempts at cannulation before attempting pre-cut. In experienced hands and in an appropriate clinical setting, pre-cut sphincterotomy appears to be an acceptable method of access into the bile duct [2,[4][5][6] . The study aims to evaluate post-ERCP success and complication rates in two different patient groups: patients submitted to CBD cannulation directly through suprapapillary fistulotomy and patients submitted to the same manoeuvre after unsuccessful standard cannulation of CBD.…”

Section: Original Articlementioning

confidence: 99%

“…Transpapillary biliary cannulation is the preferred technique to enter the common bile duct (CBD), but access from the sphincter of Oddi to the biliary tract during ERCP is not always possible using standard cannulation techniques. The success rate for deep cannulation of the biliary tree during ERCP ranges between 80% and 95% in the hands of experienced endoscopists [1,2] . When standard cannulation is not possible, alternative techniques may be used: transpancreatic pre-cut, needle-…”

Section: Introductionmentioning

confidence: 99%

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Comparison between needle-knife fistulotomy and standard cannulation in ERCP

Ayoubi¹,

Sansoè²,

Leone³

et al. 2012

WJGE

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AIM:To compare the rates of success and complications of two different methods of access into the common bile duct (CBD). METHODS:Between October 2007 and November 2008, 173 consecutive patients (71 men, 102 women, mean age 68.6 years) requiring endoscopic retrograde cannulation of the papilla and endoscopic treatment were studied. In the first 88 patients CBD cannulation was performed through supra-papillary fistulotomy (group F); in the following 85 patients standard cannulation was performed through the Oddi sphincter (group S). Indications for the procedure were: choledocholithiasis, biliary obstruction, postoperative leak, sclerosing cholangitis, and Mirizzi's syndrome. RESULTS:Deep CBD cannulation was successful in 85/88 patients (96.5%) in group F vs 60/85 patients (70.6%) in group S (P < 0.0001). The remaining 25 group S patients in whom cannulation failed were shifted to fistulotomy. Fistulotomy was successful in 21/25 patients (84%). As for complications, hyperamilasemia occurred in 7 (7.9%) group F patients vs 7 (8.2%) group S patients (P = NS); mild pancreatitis in 1 (1.1%) group F patient vs 5 (5.8%) group S patients (P = NS); bleeding in 3 (3.4%) group F patients vs 3 (3.5%) group S patients (P = NS). CONCLUSION:Needle-knife fistulotomy should represent either the first approach to therapeutic cannulation or rescue therapy after unsuccessful standard cannulation.

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Section: Discussionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison between needle-knife fistulotomy and standard cannulation in ERCP

Ayoubi¹,

Sansoè²,

Leone³

et al. 2012

WJGE

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“…Precut papillotomy using a needle knife [19] or a "precut" papillotome [20] is a method used to facilitate cannulation when the aforementioned standard methods fail (Fi gure 2). An electrocautery needle knife can be used to create an incision through the anterior wall of the maj or papilla.…”

Section: Precut Techniquesmentioning

confidence: 99%

Advances in endoscopic retrograde cholangiopancreatography cannulation

Qayed

Reid²,

Willingham³

et al. 2010

WJGE

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Endoscopic retrograde cholangiopancreatography is an important tool in the diagnosis and treatment of pancreatobiliary diseases. A critical step in this pro cedure is deep cannulation of the bile duct as failure of cannulation generally results in an aborted procedure and failed intervention. Expert endoscopists usually achieve a high rate of successful cannulation while those less experienced typically have a much lower rate and a greater incidence of complications. Prolonged attempts at cannulation can result in significant morbidity to patients, anxiety for endoscopists, unnecessary radiation exposure and inefficient patient care. Here we review the most common endoscopic techniques used to achi eve selective biliary cannulation. Pharmacologic aids to cannulation are also discussed briefly in this review.

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“…Cannulation procedure is reported to achieve a success rate of 80-95% when performed by experienced endoscopists [5][6][7][8]. In cases where selective cannulation is not feasible, generally precut papillotomy techniques are performed.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Repeat ERCP: Analysis of a Four-Year Experience

Toros¹

2013

J Gastrointest Digest Sys

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In this trial, a total of 1010 ERCP procedures performed in 410 patients at the endoscopy department of our hospital between 2006 and 2010, were retrospectively evaluated. The age, gender, complaints, pre-procedure diagnosis, the radiologic and clinical results, number of procedure repetitions and the final diagnosis were assessed. The local Ethics Committee approved this retrospective study protocol. All of the procedures were performed by the same team of endoscopists with compatible levels of ERCP experience (Mean 5 years). At our department, pethidine HCl (0.3-0.5 mg/kg), midazolam (0.03-0.07 mg/kg) and hyoscine-N-butylbromide (0.3-0.6 mg/kg) are used in the ERCP procedures for premedication and additionally, cefazolin 1 gram intravenous is routinely administered for prophyllaxis one hour before the examination. During the procedure, oxygen saturation and heart rate are monitored by pulse-oximeter. The patients were those admitted to our hospital or referred from other healthcare centers. Statistical assessment was performed by evaluating the first ERCP procedures and the repeat procedure records. Chi-square test was used to statistically analyze the results. The level of significance was set at p<0.05.

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Papillary roof incision using the Erlangen-type pre-cut papillotome to achieve selective bile duct cannulation

Cited by 107 publications

References 22 publications

Comparison between needle-knife fistulotomy and standard cannulation in ERCP

Comparison between needle-knife fistulotomy and standard cannulation in ERCP

Advances in endoscopic retrograde cholangiopancreatography cannulation

Evaluation of Repeat ERCP: Analysis of a Four-Year Experience

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