Needle-knife suprapapillary sphincterotomy avoids postprocedure pancreatitis in patients with sphincter of Oddi dysfunction of biliary type II: a report of three cases

• Published in: Surgical endoscopy Vol. 18; no. 5; pp. 868 - 870
• Main Authors: Katsinelos, P, Beltsis, A, Paroutoglou, G, Pilpilidis, I, Mimidis, K, Vradelis, S, Soufleris, K, Tsolkas, P, Arvaniti, M, Papadimitriou, A, Baltagiannis, S
• Format: Journal Article
• Language: English
• Published: Germany 01.05.2004
• Subjects: Catheterization; Common Bile Duct Diseases - surgery; Female; Humans; Middle Aged; Pancreatitis - etiology; Pancreatitis - prevention & control; Postoperative Complications - prevention & control; Sphincter of Oddi; Sphincterotomy, Endoscopic - adverse effects; Sphincterotomy, Endoscopic - methods
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-003-4269-y

We report the cases of three patients who fulfilled the criteria for sphincter of Oddi dysfunction of biliary type II and underwent needle-knife suprapapillary sphincterotomy. These patients presented with episodes of biliary-type pain after cholecystectomy and significant elevation of liver enzymes. Ultrasonography and MRI cholangiography revealed dilatation of the common bile duct, without visible stones. The patients all underwent needle-knife suprapapillary sphincterotomy because free cannulation of the common bile duct could not be achieved. Needle-knife suprapapillary sphincterotomy enabled catheterization of the common bile duct. After clearing of the common bile duct with a balloon catheter, no stones, fragments of stones, or sludge were observed to exit from the sphincterotomy. None of our patients developed postprocedure pancreatitis. When needle-knife suprapillary sphincterotomy is performed by an experienced biliary endoscopist, it is a safe and effective procedure for patients with sphincter of Oddi dysfunction of biliary type II, who otherwise constitute a high-risk group for the development of postsphincterotomy pancreatitis.