Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding.
OBJECTIVE
To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications.


METHODS
All patients referred for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) were randomly assigned to undergo ES either with a partially covered or an uncovered sphincterotome. Both patient and technical risk factors contributing to the development of post-ES bleeding were recorded and analyzed. The characteristics of bleeding was recorded during and after ES. Other complications were also compared.


RESULTS
Three-hundred and eighty-seven patients were recruited in this study; 194 patients underwent ES with a partially covered sphincterotome and 193 with conventional uncovered sphincterotome. No statistical difference was noted in the baseline characteristics and risk factors for post-ES induced hemorrhage between the 2 groups. No significant difference in the incidence and pattern of visible bleeding rates was found between the 2 groups (immediate bleeding in 24 patients with the partially covered sphincterotome vs 19 patients with the uncovered sphincterotome, P = 0.418). Delayed bleeding was observed in 2 patients with a partially covered sphincterotome and in 1 patient with an uncovered sphincterotome (P = 0.62). No statistical difference was noted in the rate of other complications.


CONCLUSIONS
The partially covered sphincterotome was not associated with a lower frequency of bleeding. Also, there was no difference in the incidence of other significant complications between the 2 types of sphincterotome.
Katsinelos
Panagiotis
P
Department of Endoscopy and Motility Unit, Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, 54635 Thessaloniki, Greece. gchatzim@med.auth.gr
Paroutoglou
George
G
Kountouras
Jannis
J
Chatzimavroudis
Grigoris
G
Zavos
Christos
C
Terzoudis
Sotiris
S
Katsinelos
Taxiarchis
T
Fasoulas
Kostas
K
Gelas
George
G
Tzovaras
George
G
Pilpilidis
Ioannis
I
D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010190:Pancreatic Neoplasms / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome