scholarly journals A simple and novel marking method for correctly identifying the precutting direction to achieve safe and efficacious precut sphincterotomy (with video)

2019 ◽  
Vol 07 (01) ◽  
pp. E3-E8
Author(s):  
Kazumasa Nagai ◽  
Akio Katanuma ◽  
Kuniyuki Takahashi ◽  
Kei Yane ◽  
Toshifumi Kin ◽  
...  
Keyword(s):  
Bile Duct ◽  
Technical Success ◽  
Tertiary Referral ◽  
Endoscopic Retrograde ◽  
Incision Length ◽  
Tertiary Referral Center ◽  
Preliminary Study ◽  
Needle Knife ◽  
The Right ◽  
Precut Sphincterotomy

Abstract Background and study aims Failure to recognize the right direction and precise incision length during precutting has been reported. To address these concerns, we developed a marking method that places a marking on the cutting endpoint before starting precutting. This preliminary study aimed to assess the effectiveness and safety of precut sphincterotomy using our new marking method. Patients and methods Between April 2015 and May 2017, 21 patients from our tertiary referral center were included in this study. Precut sphincterotomy using our marking method was employed for difficult common bile duct cannulation cases. Before starting precutting, a marking was placed slightly before the upper margin of the bulge of the papilla in the 11- to 12-o’clock direction as a cutting endpoint by cauterization with a needle knife. Results Technical success was obtained in all 21 procedures. There were no post-endoscopic retrograde cholangiopancreatography (ERCP) complications except for one mild case of post-ERCP pancreatitis. Conclusion Our new marking method before precutting enabled precise incision and quick bile duct cannulation without causing severe complications.

scholarly journals Endoscopic Hands-Off Technique versus Conventional Technique for Conversion from an Orobiliary to a Nasobiliary Tube

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Min Jae Yang ◽  
Jae Chul Hwang ◽  
Miyeon Lee ◽  
Choong-Kyun Noh ◽  
Soon Sun Kim ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Conventional Technique ◽  
Conventional Group ◽  
Procedure Time ◽  
Technical Success ◽  
Tertiary Referral ◽  
Endoscopic Retrograde ◽  
Tertiary Referral Center ◽  
Endoscopic Nasobiliary Drainage ◽  
Nasobiliary Drainage

Background. The aim of this study was to compare the outcomes of the endoscopic hands-off technique and the conventional technique when repositioning an endoscopic nasobiliary drainage (ENBD) tube from the mouth to the nose.Methods. We conducted a retrospective cohort study of all endoscopic retrograde cholangiopancreatographies (ERCPs) performed between July 2013 and May 2015 at a single tertiary referral center. A total of 1187 ERCPs were performed during the study period. Among them, 114 patients who underwent ENBD were enrolled in this study. In those patients, we used the endoscopic hands-off technique between July 2013 and May 2014 (endoscopy group) and the conventional technique between June 2014 and May 2015 (conventional group).Results. Technical success was achieved in 100% (58/58) of the endoscopy group and 94.6% (53/56) of the conventional group (P=0.115). In the 3 cases of failed conventional technique, the endoscopic hands-off technique was then performed, and conversion of the ENBD tube was successful in all of these patients. The procedure time was significantly shorter in the endoscopy group than in the conventional group (124 s versus 149 s,P=0.001).Conclusion. The endoscopic hands-off technique was feasible and effective for oral-nasal conversion of an ENBD tube.

scholarly journals Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: importance of the endoscopist’s expertise level

2020 ◽  
Author(s):  
Sung Yong Han ◽  
Dong Hoon Baek ◽  
Dong Uk Kim ◽  
Chang Joon Park ◽  
In Sub Han ◽  
...  
Keyword(s):  
Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Tertiary Referral Center ◽  
Needle Knife ◽  
Expertise Level

Abstract Background Needle-knife fistulotomy (NKF) is used as a rescue technique for difficult cannulation. However, the data are limited regarding the use of needle-knife fistulotomy for primary biliary cannulation, especially when performed by beginners. To assess the effectiveness and safety of primary NKF for biliary cannulation, and the role of the endoscopist’s expertise level (beginner vs. expert). Methods We retrospectively evaluated the records of 613 patients with naïve papilla and no history of pancreatitis, who underwent bile duct cannulation at a tertiary referral center. The patients were categorized according to the endoscopist’s expertise level and the technique used for bile duct cannulation. We assessed the rates of successful cannulation and adverse events. Results The baseline characteristics did not differ between the pre-defined groups. The incidence rate of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) was significantly affected by the endoscopist’s expertise level in patients who received conventional cannulation with sphincterotomy (11.3% vs. 5.7% for beginner vs. expert, P =0.033), but not in those who received NKF. In the multivariable analysis, a lower expertise level of the biliary endoscopist and longer cannulation time were significant risk factor of post-endoscopic retrograde cholangiopancreatography pancreatitis ( P =0.030, P =0.005) in patients who received conventional cannulation with sphincterotomy but not in those who received NKF. Conclusion Compared to conventional cannulation with sphincterotomy, primary NKF carries a lower risk of PEP regardless of the endoscopist’s level of expertise. Primary NKF may be effective and safe in achieving ductal access in patients with naïve papilla.

scholarly journals Transcystic Removal of Common Bile Duct Stones in Surgically Altered Anatomy (Roux-en-Y Gastric Bypass)

2021 ◽  
Vol 12 (03) ◽  
pp. 172-174
Author(s):  
Surakshith K. Thyloor ◽  
Vikas Singla ◽  
Pradeep Chowbey
Keyword(s):  
Gastric Bypass ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Technical Success ◽  
Endoscopic Retrograde ◽  
Technical Success Rate ◽  
Surgically Altered Anatomy ◽  
Retrieval Device

AbstractEndoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy can be technically challenging. Various techniques have been described; however, the technical success rate depends on the type of reconstruction, length of the afferent limb, access to the papilla, availability of accessories, and adequate expertise. We describe successful transcystic removal of common bile duct stones in a patient with Roux-en-Y gastric bypass using cholangioscope and SpyGlass retrieval device at the time of cholecystectomy.

Bile duct injury repairs: Progressive outcomes in a tertiary referral center

Surgery ◽  
2019 ◽  
Vol 166 (4) ◽  
pp. 698-702 ◽  
Author(s):  
Helmi Khadra ◽  
Hillary Johnson ◽  
Jason Crowther ◽  
Patrick McClaren ◽  
Michael Darden ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

Long-term results of secondary biliary repair for cholecystectomy-related bile duct injury: results of a tertiary referral center

2019 ◽  
Vol 120 (2) ◽  
pp. 92-101
Author(s):  
Julie Navez ◽  
Jean-François Gigot ◽  
Pierre H. Deprez ◽  
Pierre Goffette ◽  
Laurence Annet ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Long Term Results ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

Su1728 Needle Knife Sphincterotomy for Biliary Access At ERCP: a Tertiary Referral Center Experience

2014 ◽  
Vol 79 (5) ◽  
pp. AB382
Author(s):  
Kate Forssell ◽  
Caren E. Bartosz ◽  
Michael Winter ◽  
Shivangi Kothari ◽  
Asad Ullah ◽  
...  
Keyword(s):  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Needle Knife

Outcomes of surgery for post-cholecystectomy bile duct injuries: An audit from a tertiary referral center

2020 ◽  
Vol 157 (1) ◽  
pp. 3-11 ◽  
Author(s):  
S. Ray ◽  
S. Sanyal ◽  
S. Das ◽  
K. Jana ◽  
A.K. Das ◽  
...  
Keyword(s):  
Bile Duct ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Bile Duct Injuries

Needle-knife sphincterotomy in a tertiary referral center: efficacy and complications

1996 ◽  
Vol 44 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Franklin E. Kasmin ◽  
David Cohen ◽  
Subash Batra ◽  
Seth A. Cohen ◽  
Jerome H. Siegel
Keyword(s):  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Needle Knife

scholarly journals Transpancreatic Precut Sphincterotomy for Biliary Access: The Relation of Sphincterotomy Size to Immediate Success Rate of Biliary Cannulation

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lien-Fu Lin
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Success Rate ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
The Other ◽  
Pancreatic Stent ◽  
Biliary Cannulation ◽  
Needle Knife ◽  
Precut Sphincterotomy

Background. Transpancreatic precut sphincterotomy (TPS) is an option for difficult common bile duct (CBD) access, and the reports are few, with immediate success rate varying from 60 to 96%. The description of relation between the size of TPS and the immediate success rate of CBD cannulation was not found in the literature. The Aim of the Study. To evaluate the relation of large TPS to immediate success rate of CBD cannulation. Methods. A retrospective analysis was performed in prospectively collected data of 20 patients. TPS was performed with traction papillotome in the main pancreatic duct (MPD) directing towards 11 o’clock. Needle knife (NK) was used to enlarge TPS in five patients, and the other 15 cases had large TPS from the beginning of sphincterotomy. Prophylactic pancreatic stent was inserted in 18 cases, with diclofenac given in 12 cases. Results. The immediate success rate of CBD cannulation was 90% and with an eventual success rate of 100%. The failure in one immediate CBD cannulation with large TPS was due to atypical location of CBD orifice, and the other failed immediate CBD cannulation was due to inadequate size of TPS. Complications included 3 cases of post-TPS bleeding and 3 cases of mild pancreatitis. Conclusion. TPS is an effective procedure in patients with difficult biliary access and can have high immediate success rate with large TPS.

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