Precut Sphincterotomy is a Valuable Advanced Cannulation Technique for Difficult Biliary Duct Cannulation in Single-Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography for Surgically Altered Anatomy.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-06-04 DOI:10.1002/jhbp.12162

Masafumi Watanabe, Kosuke Okuwaki, Tomohisa Iwai, Mitsuhiro Kida, Hiroshi Imaizumi, Kai Adachi, Akihiro Tamaki, Taro Hanaoka, Chika Kusano

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引用次数: 0

Abstract

Background: In single balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography (SBE-assisted ERCP) for patients with surgically altered anatomies, precut sphincterotomy is performed as an advanced cannulation technique for difficult biliary cannulation cases. This study evaluated the safety and efficacy of precut sphincterotomy.

Methods: The study included patients who underwent SBE-assisted ERCP on a naive papilla with surgically altered anatomies (excluding Billroth-I reconstruction) from April 2015 to December 2023. The success rate of biliary cannulation and the complication incidence were analyzed retrospectively.

Results: A total of 231 patients were included. Scope insertion to the duodenal papilla was possible in 204 cases (88.3%), and biliary cannulation was attempted in 198 cases (85.7%). Standard cannulation was successful in 132 cases (66.7%), while an additional 10 cases (5.1%) successfully cannulated using pancreatic guide wire-assisted biliary cannulation. An additional 28 cases (14.1%) were successfully cannulated using precut sphincterotomy. Therefore, the overall biliary cannulation success rate was 85.9% (170 of 198 cases). The success rate of precut sphincterotomy was 66.7% (28 of 42 cases). Intraoperative bleeding caused by precut sphincterotomy occurred in 11.9%, and other complications were present in 16.7% of cases.

Conclusions: Precut sphincterotomy is a one of the valuable techniques in SBE-assisted ERCP for surgically altered anatomies.

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预切括约肌切开术是单球囊肠镜辅助内镜逆行胆管造影术中胆管插管困难的一种有价值的先进插管技术。

背景：在单球囊-肠镜辅助下的内镜逆行胆管造影（sbe辅助ERCP）中，对于手术解剖改变的患者，预切括约肌切开术是一种先进的胆道插管技术。本研究评估预切括约肌切开术的安全性和有效性。方法：研究纳入2015年4月至2023年12月在手术改变解剖结构（不包括Billroth-I重建）的未成熟乳头上接受sbe辅助ERCP的患者。回顾性分析胆道插管成功率及并发症发生率。结果：共纳入231例患者。204例（88.3%）成功插入十二指肠乳头，198例（85.7%）尝试胆道插管。标准插管132例（66.7%）成功，胰导线辅助胆道插管10例（5.1%）成功。另外28例（14.1%）采用预切括约肌切开术成功插管。总胆道插管成功率为85.9%（198例中170例）。预切括约肌切开术成功率为66.7%（28 / 42）。预切括约肌切开术中出血占11.9%，其他并发症占16.7%。结论：预切括约肌切开术是sbe辅助ERCP治疗手术改变解剖结构的一种有价值的技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.