Intramural incision technique: a useful and safe procedure for obtaining ductal access during ERCP - 23/08/11
Reprint requests: Sri P. Misra, MD, Department of Gastroenterology, Moti Lal Nehru Medical College, Allahabad 211 001, India.Allahabad, India
Abstract |
Background |
Intramucosal incision technique is a useful procedure to achieve ductal access in patients undergoing ERCP. However, the procedure has been underused.
Objective |
Our purpose was to evaluate the efficacy and safety of the intramucosal incision technique and to compare it with standard precut needle-knife papillotomy.
Setting |
A large teaching hospital.
Patients |
Patients undergoing endoscopic sphincterotomy.
Interventions |
If a complete or an incomplete false tract formed during probing for the biliary ductal system, the intramucosal incision technique was attempted. Needle-knife precut papillotomy was performed in those in whom bile duct access could not be obtained even after 4 attempts at cannulating the bile duct.
Main Outcome Measurements |
The success rate and complications of the intramucosal incision technique were compared with those for kneedle-knife papillotomy.
Results |
The intramucosal incision technique was attempted in 23 patients and was successful in 22. A definitive procedure could be performed in all 22 patients, and mild pancreatitis developed in only one of them (4.5%). During the same period, needle-knife papillotomy was attempted in 169 patients. Biliary access was gained in 159 (94%) patients. Complications occurred in 14 (8.2%) patients (mild pancreatitis in 6, moderate pancreatitis in 2, bleeding requiring endoscopic therapy in 5, and perforation in 1 patient).
Limitations |
Single center study.
Conclusions |
Intramucosal incision technique is a very useful and safe procedure and should be performed if a false tract has formed during probing for ductal access during ERCP.
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Vol 67 - N° 4
P. 629-633 - aprile 2008 Ritorno al numero
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- Yogesh M. Shastri, Nicolas Hoepffner, Angelika Tessmer, Hans Ackermann, Oliver Schroeder, Jürgen Stein
- Intramural incision during ERCP: turning a complication into a positive experience?
- Simon K. Lo
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