Endoscopy 2025; 57(S 02): S234-S235
DOI: 10.1055/s-0045-1805572
Abstracts | ESGE Days 2025
Moderated poster
ERCP and EUS: moving forward together 04/04/2025, 11:30 – 12:30 Poster Dome 2 (P0)

Precut sphincterotomy: Indications and Complications

Authors

  • R El Jim

    1   Faculty of Medicine and Pharmacy Fez, Fès, Morocco

  • L Maria

    2   CHU HASSAN II FES, Fes, Morocco

  • L Asmae

    3   CHU HASSAN II FES, Morocco, Fes, Morocco

  • H Abid

    2   CHU HASSAN II FES, Fes, Morocco

  • N Lahmidani

    2   CHU HASSAN II FES, Fes, Morocco

  • A Elmekkaoui

    2   CHU HASSAN II FES, Fes, Morocco

  • Y M El

    3   CHU HASSAN II FES, Morocco, Fes, Morocco

  • E A Mohammed

    4   Fes, Morocco

  • S A Ibrahimi

    3   CHU HASSAN II FES, Morocco, Fes, Morocco

  • D A Benajah

    5   CHU HASSAN II FES,MOROCCO, Fes, Morocco
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Aims The aim of our study is to analyze the utility and complications associated with this technique.

Methods We conducted a retrospective study on patients admitted for ERCP between 2009 and December 2023. A comparison was made between the indications and outcomes of patients who underwent pre-cut sphincterotomy and those who received standard cannulation techniques

Results A total of 4,092 ERCPs were performed. Pre-cut sphincterotomy (infundibulotomy) was used in 282 patients (7%), with a mean age of 63.2 years and a male-to-female ratio of 1.88.The indications for ERCP in this group were as follows: malignant tumor pathology in 48% of cases and benign pathology in the remaining patients. Pre-cut sphincterotomy enabled access to the bile duct after failure of standard techniques in 93% of patients. Failure of the pre-cut technique occurred in 20 patients (7%), among whom 14 patients underwent a repeat ERCP, allowing access to the bile duct after either enlarging the pre-cut in 8 cases or spontaneously in 3 cases. Follow-up of patients during and after the procedure revealed the following complications: acute pancreatitis in 10 patients (3%), 12 cases of bleeding during the procedure controlled with balloon tamponade, and 1 case requiring radiological embolization. Three cases of perforation were observed following pre-cut enlargement. In the standard cannulation group, the most common indication for ERCP was bile duct stones in 76% of cases. Complications included pancreatitis in 24 cases, bleeding after large sphincterotomy in 17 cases, perforation in 4 cases, and a subcapsular liver hematoma in 1 case.

Conclusions The results of this study demonstrate the effectiveness of pre-cut sphincterotomy as a useful technique in difficult bile duct cannulation cases. The comparison of complications between the two groups did not reveal any significant differences. The causal relationship between the use of this technique and the occurrence of complications was not established in our study



Publication History

Article published online:
27 March 2025

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