Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis.
OBJECTIVE
To evaluate whether an automatically controlled cut system (endocut mode) could reduce the complication rate of endoscopic sphincterotomy (EST) and serum hyperamylasemia after EST compared to the conventional blended cut mode.


METHODS
From January 2001 to October 2003, 134 patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure.


RESULTS
Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group (9%): hyperamylasemia (5 times higher than normal) in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group (16%): hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST (P<0.02). The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group (P<0.05).


CONCLUSIONS
Endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.
Akiho
Hirotada
H
Division of Gastroenterology, Aso Iizuka Hospital, Japan. akiho@intmed3.med.kyushu-u.ac.jp
Sumida
Yorinobu
Y
Akahoshi
Kazuya
K
Murata
Atsuhiko
A
Ouchi
Jiro
J
Motomura
Yasuaki
Y
Toyomasu
Taisuke
T
Kimura
Mitsuhide
M
Kubokawa
Masaru
M
Matsumoto
Masahiro
M
Endo
Shingo
S
Nakamura
Kazuhiko
K
D000368:Aged; D000681:Amylases / Q000097:blood; D042883:Choledocholithiasis / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D012449:Safety; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000379:methods*
D000681:Amylases