Needle knife papillotomy with discarded sphincterotomes: Cost effective and safe

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Annals of Gastroenterology
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Needle knife papillotomy with discarded sphincterotomes: Cost effective and safe (EN)

Niraj, S.
Rathi, P.M.
Nistala, S.
Narendhran, R.T.
Madhu, S.

Background: Efficacy of therapeutic biliary endoscopy depends on the success rate of selective cannulation of common bile duct. Precut papillotomy using a needle knife is a technique used to improve access to common bile duct. The cost of the procedure increases exponentially with the use of special accessories like a needle knife. We evaluated the safety and efficacy of a needle knife made out of discarded sphincterotomes at our institute. Methods: Prospectively collected non-randomized data was analysed at an academic tertiary referral center. The study included all patients in a two-year period that underwent endoscopic retrograde cholangiopancreatography. The main outcome measures of the study were success and complications of precut papillotomy done using a needle knife shaped out of discarded sphincterotomes. Observations: 438 ERCPs were performed during the study period and 78 patients (17.81%) needed a precut papillotomy. Selective biliary cannulation after precut papillotomy with the newly prepared needle knife was successful in 100 % of cases. Complications seen in 7 % of cases, were similar to those observed in other studies and none of them were life threatening. Conclusion: Precut papillotomy using needle knife made out of discarded sphincterotomes is effective and safe when performed by an experienced endoscopist. In a developing economy where cost of medical treatment is a major obstacle in providing health care, small innovations like the above will help in decreasing the cost of endoscopic retrograde cholangiopancreatography. (EN)


Αγγλική γλώσσα


Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 23, No 1 (2010); 48 - 52 (EN)

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