Endoscopy 2010; 42(4): 338-341
DOI: 10.1055/s-0029-1243857
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

Precut sphincterotomy using insulated angulotome

P.  W.  Y.  Chiu1 , E.  K.  W.  Ng1 , A.  Y.  B.  Teoh1 , S.  K.  H.  Wong1 , J.  J.  Y.  Sung2 , J.  Y.  W.  Lau1
  • 1Department of Surgery, Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
  • 2Department of Medicine and Therapeutics, Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
Further Information

Publication History

submitted 5 November 2009

accepted after revision 26 November 2009

Publication Date:
09 February 2010 (online)

A newly designed insulated angulotome was evaluated in a series of patients in whom biliary cannulation using conventional methods had failed and who required precut sphincterotomy. The new device consists of an insulated glass tip to prevent excessive electrocautery flow, and angulation to facilitate elevation of the papillary roof on cutting. A prospective series of patients with cholangitis or obstructive jaundice with failed biliary cannulation were recruited. The success of cannulation and complications following endoscopic retrograde cholangiopancreatography were analyzed. A total of 13 patients underwent precut sphincterotomy using the insulated angulotome. The immediate success of gaining biliary access after failed cannulation was 100 %. The mean size of the common bile duct on ultrasonography was 8.1 mm. The mean time to achieve biliary cannulation was 9 minutes 4 seconds, and there was no perforation or bleeding. This case series showed that precut sphincterotomy with the insulated angulotome can be safely performed without major complications.

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P. W. Y. ChiuMD 

Department of Surgery
Prince of Wales Hospital
The Chinese University of Hong Kong

30–32 Ngan Shing Street
Shatin
NT Hong Kong 000000
Hong Kong

Fax: +852-26377974

Email: philipchiu@surgery.cuhk.edu.hk

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