Katsinelos P, Mimidis K, Paroutoglou G, Christodoulou K, Pilpilidis I, Katsiba D, Kalomenopoulou M, Papagiannis A, Tsolkas P, Kapitsinis I, Xiarchos P, Beltsis A, Eugenidis N
Department of Endoscopy, Central Hospital, Thessaloniki, Greece.
Hepatogastroenterology. 2004 Mar-Apr;51(56):349-52.
BACKGROUND/AIMS: Results from studies evaluating needle-knife papillotomy are conflicting. The aim of this retrospective study was to assess the safety and efficacy of needle-knife papillotomy as a precut procedure to achieve biliary access during ERCP.
During a period of seven years, ERCP was performed 938 times. During this time, needle-knife papillotomy was carried out in 68 patients, with complete follow-up obtained in all patients. The follow-up concentrated on the safety and efficacy of the procedure and short-term complications.
Cannulation of the common bile duct was successful immediately after needle-knife papillotomy in 44 patients (66%), during a second ERCP in 18 patients (26%), and in a third ERCP in 2 patients (3%) achieving a total cannulation rate of 94%. There were no needle-knife papillotomy related deaths. Complications included bleeding in 5 patients (7%), and pancreatitis in 3 patients (4%). All complications were managed conservatively.
Our experience indicates that needle-knife papillotomy is a versatile, effective and safe technique of gaining biliary access in patients in whom deep cannulation proves impossible and biliary access is considered essential.
背景/目的：评估针刀乳头切开术的研究结果相互矛盾。这项回顾性研究的目的是评估针刀乳头切开术作为一种预切开操作在ERCP期间实现胆管插管的安全性和有效性。
在七年的时间里，进行了938次ERCP。在此期间，对68例患者实施了针刀乳头切开术，所有患者均获得了完整的随访。随访集中在该操作的安全性和有效性以及短期并发症上。
44例患者（66%）在针刀乳头切开术后立即成功实现胆总管插管，18例患者（26%）在第二次ERCP时成功，2例患者（3%）在第三次ERCP时成功，总插管率为94%。没有与针刀乳头切开术相关的死亡病例。并发症包括5例患者出血（7%），3例患者发生胰腺炎（4%）。所有并发症均经保守治疗。
我们的经验表明，针刀乳头切开术是一种多功能、有效且安全的技术，可用于那些无法进行深部插管且胆管插管被认为至关重要的患者以实现胆管插管。
