title: Endoscopic pancreatic sphincterotomy: indications and complications.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Yong Won
authors.initials: YW
authors.lastname: Joo
authors.forename: Jai Hoon
authors.initials: JH
authors.lastname: Yoon
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Cho
authors.forename: Kang Nyeong
authors.initials: KN
authors.lastname: Lee
authors.forename: Na Rae
authors.initials: NR
authors.lastname: Ha
authors.forename: Hang Lak
authors.initials: HL
authors.lastname: Lee
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Lee
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoon
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Choi
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Hahm
authors.forename: Dong Hoo
authors.initials: DH
authors.lastname: Lee
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Lee
mesh_terms: 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*