EVALUATING THE COMBINATION OF WIRE ASSISTED CANNULATION AND PURE-CUT SPHINCTEROTOMY DURING THERAPEUTIC ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: A PROSPECTIVE CASE SERIES STUDY

Aims:

Post Endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is a well-known complication of endoscopic retrograde cholangiopancreatography (ERCP) (Bilbao et al., 1976; Freeman, 2012), ranging from biochemical rise of amylase to severe fatal necrotising pancreatitis (Talukdar, 2016). Since pancreatitis is a preventable complication, technical optimisation at pre, intra and post procedural levels should be carried out to reduce the risk (Kahaleh et al., 2012). Trying to implement the best approach to lower the risk of pancreatitis, combination of wire assisted cannulation and pure-cut sphincterotomy technique were adopted, since each of these techniques is individually proven to be associated with lower risk of pancreatitis.

Methods:

Prospective large case series study.

Results:

Over two years period, therapeutic ERCP was performed for 311 patients (123 males and 188 females) for various indications, patients ages ranging from 26 – 97 (males) and 14 – 93 (Female). PEP happened in 5 patients of the entire number of patients (1.6%). Only 1 of them was male (0.8%) while the other 4 patients were female (2.1%). No perforation, nor significant bleeding that required blood transfusion or extension of hospitalisation have happened.

Conclusions:

Combination of wire assisted cannulation with pure-cut sphincterotomy technique appears to be safe, cost effective, with high success rate and low risk of PEP.