Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 19 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Primary precutting in endoscopy is safe for bile duct access

Using primary precutting appears to be as safe as a conventional approach that applies guide-wire-based common bile duct cannulation, shows this month's Endoscopy.

News image

fiogf49gjkf04

Precut is a well-known technique that is used if repeated attempts at common bile duct cannulation fail.

However, opinions on the complication rate of precut are conflicting.

Dr de Weerth and colleagues from Germany evaluated the efficacy and complication rate of precut used as a primary method of common bile duct access.

The researchers compared this with the efficacy and safety of the conventional technique during a 19-month study period.

The team evaluated consecutive patients who were scheduled for first-time endoscopic sphincterotomy for a variety of biliary disorders.

The researchers randomized 291 patients were randomized into 2 groups.

The team reported that 146 patients in Group 1 underwent conventional wire-guided biliary cannulation followed by endoscopic sphincterotomy.

The success rate using a primary precut was 100%
Endoscopy

The team evaluated 145 patients in Group 2 using precut as a primary technique to gain biliary access, followed by wire-guided endoscopic sphincterotomy.

The researchers applied a specially designed, modified Erlangen type of sphincterotome for precutting.

The indications for endoscopic sphincterotomy were comparable in the 2 groups.

In Group 1, the team found that wire-guided cannulation of the common bile duct failed in 42 patients.

Secondary precut was successful in 41 of these patients, leading to an overall success rate of 99%.

In Group 2, the team noted that endoscopic sphincterotomy success rate using primary precut was 100% at the first attempt.

The researchers observed that the mean time to successful deep common bile duct cannulation was 8 minutes in Group 1.

In addition, the team found that the mean time to successful deep common bile duct cannulation was 7 minutes in Group 2.

The incidence of mild to moderate pancreatitis was similar in the 2 groups.

Mild bleeding occurred in only 1 patient and this was controlled by epinephrine injection.

The team reported that none of the study patients developed severe pancreatitis or perforation.

Dr de Weerth's team concluded, “In experienced hands, an approach using primary precut appears to be at least as successful and safe as a conventional approach using guide-wire-based common bile duct cannulation followed by endoscopic sphincterotomy, and might also be a quicker method.”

Endoscopy 2006: 38: 1235-40
21 December 2006

Go to top of page Email this page Email this page to a colleague

 19 February 2018 
The effectiveness of screening colonoscopy in the right colon was not significantly different from that in the left colon/rectum
 19 February 2018 
No significant differences, among racial or ethnic groups, found in patients with significant fibrosis
 19 February 2018 
Hydrogen production greater in patients on a fructan-containing diet, than those following a maltodextrin-containing diet

 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Management of hemorrhoids in the USA
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia
 25 January 2018 
Predicting intra-abdominal infections after colorectal surgery
 25 January 2018 
Predictors of gastric cancer risk
 24 January 2018 
Risk factors underlying previously undiagnosed cirrhosis
 24 January 2018 
Ethnicity influences phenotype in IBD
 24 January 2018 
Bariatric surgery vs medical obesity treatment
 23 January 2018 
Atrophic gastritis after H. pylori eradication
 23 January 2018 
Ectopic pregnancy in women with IBD
 23 January 2018 
Celiac disease in IBS in the USA

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us