Irfan Ahmad, Anwaar A Khan, Altaf Alam, Arshad Kamal Butt, Farzana Shafqat, Shahid Sarwar.
Precut papillotomy outcome.
J Coll Physicians Surg Pak Jan ;15(11):701-3.

Objective: To determine the success and complications of precut papillotomy using needle knife technique in common bile duct cannulation. Design: Quasi interventional. Place and Duration of Study: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Sheikh Zayed Hospital, Lahore from April 2001 to August 2003. Materials and Methods: From April 2001 to August 2003, a total of 347 ERCPs were performed at our institution. During this period, precut papillotomy was carried out in 79 patients. The data of these patients was evaluated for the success of the procedure and occurrence of short-term complications. Other parameters such as age and gender of patients, appearance of ampulla, and the diagnoses were also recorded. Results: Fortyfive patients were women and 34 men. The mean age was 52 years (range 12-80 years). Precut helped to cannulate common bile duct in 67 patients at first attempt and in further 5 patients at second attempt with an overall success rate of 91.14%. Complications occurred in 8 (10.1%) patients. These include hemorrhage in 5 (6.3%) patients and pancreatitis in 3 (3.8%). All complications were managed conservatively. Conclusion: Precut papillotomy is an effective technique in cannulating common bile duct in difficult cases with margin of safety, dependent on expertise.

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