Comparison of early pre-cutting vs standard technique for biliary cannulation in endoscopic retrograde cholangiopancreatography: a personal experience.
OBJECTIVE
To compare the results and complications of early pre-cutting technique with standard technique.


METHODS
From January 2003 to December 2004, a total of 416 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist (T.A.). Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures (70.4%) were done with standard technique (group A) and 123 procedures (29.6%) with early pre-cutting technique in case of difficult cannulation (group B). The results and complications of ERCP were compared.


RESULTS
Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group B. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred.


CONCLUSIONS
For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.
Department of Surgery, Siriraj GI Endoscopy center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Kannikar
K
Laohavichitra
Thawatchai
T
Akaraviputh
Asada
A
Methasate
Somchai
S
Leelakusolvong
Udom
U
Kachintorn
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000601:surgery*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D002761:Cholangitis / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D016896:Treatment Outcome