Pure Versus Mixed Electrosurgical Current for Endoscopic Biliary Sphincterotomy: A Meta-Analysis of Adverse Outcomes

Prevention of post-ERCP pancreatitis

“…The difference was not statistically significant. Bleeding was seen in 37% in the pure cutting current and 12% in the blended current group (29). Consequently, it is believed that the type of current does not affect the incidence of PEP.…”

Math, myth and the fundamentals of electrosurgery

“…The low voltages don't produce any cut and the power drop during the resection would lead to stalling or snare entrapment. For these indications, higher voltage outputs which have at least some cutting ability are matched with "broad" power curves [4,5,13] (Figure 6). In these broad curves, as resistance rises during the resection, the ESU keeps the power being delivered to a tightly controlled and fairly constant range around a selected power setting.…”

“…Table 1 generators with Pulse Cut and/or Pulse Blend Cuts are available from Boston Scientific, Conmed, Erbe, Genii and Olympus. Multiple studies to date have shown that no one algorithm is superior to the others for significantly reducing complications during sphincterotomy and no large comparative studies are available for polypectomy [4,6,13].…”

ERCP in acute cholangitis

“…The cutting wire of the sphincterotome is then bowed to maintain contact with the roof of the papilla, and cutting is performed by maintaining contact between the distal tip of the wire and the papilla using either the endocut mode or a blended current consisted of high cutting and low coagulation current (Figure 14.2) [14,15]. The cutting wire of the sphincterotome is then bowed to maintain contact with the roof of the papilla, and cutting is performed by maintaining contact between the distal tip of the wire and the papilla using either the endocut mode or a blended current consisted of high cutting and low coagulation current (Figure 14.2) [14,15].…”