Uchida Naohito, Tsutsui Kunihiko, Kamada Hideki, Ogawa Mutsumi, Fukuma Hiroki, Ezaki Toru, Aritomo Yuichi, Kobara Hideki, Ono Masahiro, Morishita Asahiro, Masaki Tsutomu, Watanabe Seishiro, Nakatsu Toshiaki, Kuriyama Shigeki
Third Department of Internal Medicine, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
J Gastroenterol Hepatol. 2005 Jun;20(6):947-50. doi: 10.1111/j.1440-1746.2005.03904.x.
The technical success of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) depends on selective cannulation into the bile duct. We have developed a new type of precut papillotome for selective cannulation.
The newly developed precut papillotome has been equipped not only with a lumen for contrast materials but also with an independent lumen for the guidewire. The operation of the guidewire and the injection of contrast material can be carried out simultaneously. The precut papillotome has a 20-mm-long knife and no leading tip. Half the proximal side of the knife is coated for insulation.
Selective biliary cannulation failed in 26 of 293 patients (8.9%) in whom therapeutic ERCP was attempted. We applied the precut papillotome to these 26 patients and selective cannulation was successful in 24 of 26 patients (success rate: 92.3%). No major complications occurred, although mild bleeding, which did not require endoscopic hemostasis or blood transfusion, was observed only in one patient.
Although further studies with a large number of patients are needed to evaluate the efficacy of the papillotome, this papillotome may contribute to increase the safety and the success rate of precutting.
治疗性内镜逆行胰胆管造影术（ERCP）的技术成功取决于选择性胆管插管。我们开发了一种新型的预切开乳头切开刀用于选择性插管。
新开发的预切开乳头切开刀不仅配备了用于造影剂的腔道，还配备了用于导丝的独立腔道。导丝操作和造影剂注射可同时进行。预切开乳头切开刀有一把20毫米长的刀且无前端。刀的近端一半进行了绝缘涂层处理。
在293例尝试进行治疗性ERCP的患者中，26例（8.9%）选择性胆管插管失败。我们将预切开乳头切开刀应用于这26例患者，26例中有24例选择性插管成功（成功率：92.3%）。未发生重大并发症，尽管仅1例患者出现轻度出血，无需内镜止血或输血。
尽管需要大量患者的进一步研究来评估乳头切开刀的疗效，但这种乳头切开刀可能有助于提高预切开的安全性和成功率。
