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Volume 7 Issue 6 (June, 2019)

Original Articles

Outcomes of transpancreatic sphincterotomy with and without prophylactic pancreatic stent in cases with difficult biliary cannulation
Sabir Hussain, Sewa Ram, Sunil Kumar Dadhich, Narendra Bhargava, Naveen Kumar

Background and aim: Alternative techniques of biliary cannulation are often required during endoscopic retrograde cholangiopancreatography (ERCP). Technical difficulty, success rates and complications associated with these techniques may vary. In this study, we aimed to evaluate and compare the efficacy of transpancreatic sphincterotomy (TPS) with or without pancreatic duct (PD ) stenting in cases with difficult biliary cannulation. Methods: The data of consecutive patients with difficult biliary access (January 2016 to June 2017) during ERCP was analyzed, retrospectively. Cases who underwent biliary cannulation via TPS were included in the study. Clinical success and complications were compared between the PD stent and no PD stent groups. Results: A total of 764 patients underwent ERCP during the study period. Of these, TPS was utilized in 59 patients. TPS was technically successful in all the patients. Clinical success was recorded in 57 patients (96.6%). There was no significant difference in clinical success between the two groups(PD stent 96.77% vs No PD stent 96.4%; P=1.000). Minor adverse events were noticed in 5 patients including mild pancreatitis (3) and intraprocedural bleeding (2). Adverse events were similar in cases with and without prophylactic PD stent placement (6.45% vs 7.14%, p=0.661). Conclusion: TPS is a safe and effective technique in cases with difficult biliary cannulation. The placement of prophylactic PD stent does not appear to effect the incidence of complications after TPS. Key words: endoscopy; cholangiopancreatography; complications.

 
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