Safety and efficacy of pancreatic sphincterotomy in XXXX .

@entity1 @entity788 @entity1689 @entity548
BACKGROUND: @entity788 ( @entity788 ) is being performed with increasing frequency as a prerequisite to interventional measures in the pancreatic duct. The aim of this study was to evaluate @entity788 with regard to technique, success, complications, and mortality in @entity1 with @entity1689 . METHODS: Between January 1989 and September 1996, the results of all consecutive EPSs in @entity1 with @entity1689 were documented in a standardized form. @entity1 were followed by clinical investigation and blood sample analysis at 4, 24, and 48 hours after @entity788 . Complications were classified according to commonly accepted criteria. RESULTS: @entity788 was performed in 118 @entity1 with @entity1689 ( @entity1 75%, @entity1 25%, 48+/-10 years). Ninety-four @entity1 (80%) underwent guidewire-assisted @entity788 , and 24 @entity1 (20%) underwent needle-knife @entity788 . Seventy-seven @entity788 procedures (65%) were primarily successful (guidewire @entity788 : 60 of 94, 64%; needle-knife @entity788 : 17 of 24, 71%). Additional endoscopic cutting techniques (needle-knife papillotomy, biliary endoscopic sphincterotomy) were required in 41 @entity1 (35%). In total, @entity788 was successful in 116 @entity1 (98%). The complication rate was 4.2% (4 cases of moderate @entity788 , 1 severe @entity548 , no deaths). All complications were managed nonoperatively. CONCLUSIONS: In @entity1 with @entity1689 , @entity788 with a standard sphincterotome or with a needle-knife offers an effective and reliable approach to the pancreatic duct system. Additional cutting techniques may be necessary in approximately one third of cases before an @entity788 can be successfully performed. The complication rate of @entity788 in @entity1 with @entity1689 appears to be lower than the complication rate of biliary sphincterotomy for other indications.
