NEEDLE-KNIFE SPHINCTEROTOMY AS A PRECUT PROCEDURE IN PATIENTS WITH NON-DILATED BILIARY TRACT: TECHNICAL SUCCESS RATE AND COMPLICATION RATE

Aims Needle-knife sphincterotomy as a precut procedure (PS) in patients with non-dilated bile duct carries an increased risk of complications. Working hypothesis: A targeted PS with identification of the papillary submucosal common bile duct does not imply a greater risk of complications.

Methods Retrospective analysis of prospectively collected data. We included patients that underwent PS between 2014 and 2021; all the PS were performed by the same endoscopist. The PS technique consisted of: superficial mucosal incision in cranial direction, submucosal dissection, identification of the submucosal common bile duct and deepening the cut at this level.

Collected data included: demographic data, technical success rate, complication rate, cannulation time, ERCP duration, and diameter of the bile duct. We defined cannulation time as the time elapsing from the beginning of the cannulation attempts until bile duct access was achieved. We defined bile duct dilation as a bile duct caliber≥7 mm. Patients were divided into two groups: those with a non-dilated bile duct (Group I) and those with a dilated bile duct (Group II). The study was approved by the institutional review board.

Results We included 98 patients with a mean age of 74.51±14 years (range: 26-95); 56% were male. Group I comprised 64 patients and Group II 34 patients. The global technical success of the PS was 84%.

Conclusions Performing PS by identifying the submucosal common bile duct does not imply a greater risk of complications in patients with a non-dilated bile duct.

Publication History

Article published online:
14 April 2022