Needle knife sphincterotomy--the Chris Hani Baragwanath Academic Hospital experience

• Published in: South African journal of surgery Vol. 55; no. 2; p. 55
• Main Authors: Thomson, J.T, Smith, M.D, Omoshoro-Jones, J.A.O, Devar, J.D, Khan, Z.K, Jugmohan, B.J
• Format: Journal Article
• Language: English
• Published: South African Sports Medicine Association 01.06.2017
• Subjects: Analysis; Endoscopic retrograde cholangiopancreatography; Sphincterotomy; Treatment outcome
• ISSN: 0038-2361

Background Deep biliary cannulation is essential in performing a therapeutic ERCP. Cannulation can be enhanced through the utilization of a pre-cut by means of a needle knife sphincterotomy. Aim This study is to assess the application of the needle knife sphincterotomy in a cohort of patients, both at initial ERCP and repeat ERCP. Methods Retrospective analysis of the Chris Hani Baragwanath Academic Hospital's ERCP database was performed. All ERCPs performed with the aid of a needle knife were identified and analysed for successful and unsuccessful deep biliary cannulation. Results 2830 ERCPs were performed during the study period. 369 (13%) required needle knife sphincterotomies and successful deep biliary cannulation was achieved in 229 (62%) of these patients. Repeat ERCPs were performed on 125 (34%) patients. 61 (49%) of the repeat ERCPs were performed because of previously failed cannulation. 34 (56%) of these repeat ERCPs resulted in successful deep biliary cannulation at re-attempt. 99% of successful cannulations at repeat ERCP had had a needle knife sphincterotomy at the first ERCP. Discussion Needle knife sphincterotomy improves deep biliary cannulation at initial ERCP and subsequent ERCPs with low incidences of complications.