Endoscopic pancreatic sphincterotomy: indications and complications.
OBJECTIVE
Although a few recent studies have reported the effectiveness of endoscopic pancreatic sphincterotomy (EPST), none has compared physicians' skills and complications resulting from the procedure. Thus, we examined the indications, complications, and safety of EPST performed by a single physician at a single center.


METHODS
Among 2,313 patients who underwent endoscopic retrograde cholangiopancreatography between January 1996 and March 2008, 46 patients who underwent EPST were included in this retrospective study. We examined the indications, complications, safety, and effectiveness of EPST, as well as the need for a pancreatic drainage procedure and the concomitant application of EPST and endoscopic sphincterotomy (EST).


RESULTS
Diagnostic indications for EPST were chronic pancreatitis (26 cases), pancreatic divisum (4 cases), and pancreatic cancer (8 cases). Therapeutic indications for EPST were removal of a pancreaticolith (10 cases), stent insertion for pancreatic duct stenosis (9 cases), nasopancreatic drainage (7 cases), and treatment of sphincter of Oddi dysfunction (1 case). The success rate of EPST was 95.7% (44/46). Acute complications of EPST included five cases (10.9%) of pancreatitis and one of cholangitis (2.2%). EPST with EST did not reduce biliary complications. Endoscopic pancreatic drainage procedures following EPST did not reduce pancreatic complications.


CONCLUSIONS
EPST showed a low incidence of complications and a high rate of treatment success; thus, EPST is a relatively safe procedure that can be used to treat pancreatic diseases. Pancreatic drainage procedures and additional EST following EPST did not reduce the incidence of procedure-related complications.
Joo
Yong Won
YW
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Yoon
Jai Hoon
JH
Cho
Seung Chul
SC
Lee
Kang Nyeong
KN
Ha
Na Rae
NR
Lee
Hang Lak
HL
Lee
Oh Young
OY
Yoon
Byung Chul
BC
Choi
Ho Soon
HS
Hahm
Joon Soo
JS
Lee
Dong Hoo
DH
Lee
Min Ho
MH
D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D010183:Pancreatic Ducts / Q000601:surgery; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000379:methods*