XXXX : pancreaticobiliary sphincterotomy with pancreatic stent placement has a lower rate of @entity788 than biliary sphincterotomy alone.

@entity1 @entity4 @entity1690 @entity788
BACKGROUND AND STUDY AIMS: @entity1 with suspected or documented @entity1690 ( @entity1690 ) who undergo standard biliary sphincterotomy have high rates of post-procedure @entity788 . Approximately 75% of such @entity1 have elevated basal pressures of the pancreatic sphincter. Biliary sphincterotomy (BES) on its own leaves the pancreatic sphincter unablated and may cause transient @entity4 which aggravates the increase in pancreatic sphincter pressure. Combined pancreaticobiliary therapy (PBR), using pancreatic stenting in addition to sphincterotomy may therefore be safer. @entity1 AND METHODS: The endoscopic retrograde cholangiopancreatography (ERCP) database was queried for @entity1 with successful double-duct sphincter of Oddi manometry (SOM) who underwent BES alone or PBR between 1994 and 1997. The endoscopist had decided on the technique to be used. From 1995 to 1997 there was a general trend to do PBR. @entity788 was defined according to established criteria. RESULTS: The post-ERCP @entity788 rate among all 436 @entity1690 @entity1 was 19.7%, while 256 @entity1 with normal SOM results had a @entity788 rate of 12.9%. The use of combined PBR was associated with a lower frequency of @entity788 compared with BES alone (needle-knife over pancreatic duct stent, 14/131 @entity1 , 10.7 %; pull-type pancreaticobiliary sphincterotomy plus pancreatic stent, 15/78 @entity1 , 19.2%; BES alone, 52/184 @entity1 , 28.3%). Episodes of moderate and severe @entity788 were seen more frequently in the BES group. CONCLUSION: In @entity1690 @entity1 , post-ERCP @entity788 rates remain high, but have improved with the addition of combined pancreaticobiliary sphincter therapy.
