The impact of sphincterotome design on selective cannulation of the common bile duct

Abstract

There was a significant difference in cannulation success between the two different sphincterotome. 5.5F Ultratome with guidewire was superior to 5.5F Endo-flex sphincterotome with guidewire in initial selective cannulation of common bile duct. The results may show the importance of sphincterotome features to overcome the obstacles during cannulation such as complex intrapapillary mucosal features.

Comparison between double‐guidewire technique and transpancreatic sphincterotomy technique for difficult biliary cannulation

“…Grade of cannulation difficulty for a given ERCP procedure may differ when different methods are used, so the question of how to evaluate the grade of cannulation difficulty has remained . However, time to cannulation is a more objective and more accurate assessment tool for grading cannulation difficulty than the number of attempts, so we recorded data of cannulation time in order to evaluate the difficulty of different methods …”

“…14 However, time to cannulation is a more objective and more accurate assessment tool for grading cannulation difficulty than the number of attempts, so we recorded data of cannulation time in order to evaluate the difficulty of different methods. 15 Selective cannulation of CBD can be difficult, so multiple strategies have been developed to overcome this situation. It is important to have in mind that the goal of all techniques is to decrease the rate of PEP.…”

The Comparison of Two Different 5.5 Fr Sphincterotomes for Selective Cannulation of the Common Bile Duct: A Prospective, Randomized Study

“…In contrast, a randomized, controlled trial found no difference in cannulation rates, procedure time, or complication rates between 4 and 5 Fr sphincterotomes [9]. Recently, our group tested the cannulation success by same size sphincterotomes of different manufacturers [10] and found the 5.5-Fr Ultratome with GW was superior to 5.5 Fr Endo-flex sphincterotome with GW in achieving initial selective CBD cannulation (92 vs. 81 %). We decided to perform a prospective, randomized, crossover study using these two sphincterotomes to determine initial cannulation success and adverse events in patients with naive papillae.…”

“…In designing the study, power analysis was conducted by using the chi-square test to detect differences at a 5 % significance level at a power of 80 %, considering the cannulation success rates of wire-guided methods, 82 versus 95 % on lower and upper averages of reported literature, respectively [10][11][12][13][14]. Each group required nearly 140 patients based on power analysis.…”

Methotrexate in the Treatment of Autoimmune Hepatitis

“…1 In Clinical Gastroenterology and Hepatology, several reports have shown that mycophenolate mofetil, tacrolimus, 6-mercaptopurine, and 6thioguanine are effective and safe second-line therapies for AIH. [2][3][4][5][6] More recently, Haridy et al 7 reported efficacy and safety of methotrexate (MTX) as alternative therapy in 11 adult AIH patients. To provide additional information their findings, we present a patient who consecutively developed AIH and rheumatoid arthritis (AIH, followed by rheumatoid arthritis) and successfully managed by MTX during follow up.…”