Abstract
PANCREATIC DUCT SPHINCTEROTOMY: A VALUABLE TECHNIQUE APPLIED TO DIFFICULT COMMON BILE DUCT CANNULATION
HC Abasolo, DE Rosello, EA Gabriel
Cebu Doctors’ University Hospital
Significance: In certain instances, cannulating the common bile duct (CBD) remains to be a challenge to therapeutic endoscopist. Pancreatic duct sphincterotomy, a technique referred also as transpancreatic precut sphincterotomy, has been used to access difficult cannulation of CBD with an immediate success rate of 60-90%1. The aim of this study is to present a single center’s experience of such technique along with its success rate, indications and identified complications.
Methodology: Eighty three patients who underwent endoscopic retrograde cholangiopancreatography using pancreatic duct sphincterotomy technique to access the CBD was retrieved from the endoscopy unit’s patient’s record from January 2014 to December 2018. Only 72 were retrospectively analyzed due to the unavailability of charts. Pancreatic duct sphincterotomy was used on cannulations that were deemed difficult and when initial standard technique failed.
Results: The success rate of CBD cannulation was 96.4% while failed access to CBD was only 3.6%. A periampullary diverticulum, an anatomic obstacle to sphincterotomy, was noted among 27% of successfully cannulated patients. Procedure-related complications was 18% in which bleeding (mild: 2.7%, moderate:4.1%) and pancreatitis (mild:8.3%, moderate:4.2%) were the only ones identified while 81.9% did not have any complications.
Conclusion: Pancreatic duct sphincterotomy is an effective technique for difficult bile duct cannulation with minimal mild to moderate bleeding and pancreatitis as the only procedure-related complication.
Keywords: pancreatic duct sphincterotomy, difficult bile duct cannulation, successful cannulation
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |