Department of Surgery, Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hong Kong 000000, Hong Kong.
Endoscopy. 2010 Apr;42(4):338-41. doi: 10.1055/s-0029-1243857. Epub 2010 Feb 9.
A newly designed insulated angulotome was evaluated in a series of patients in whom biliary cannulation using conventional methods had failed and who required precut sphincterotomy. The new device consists of an insulated glass tip to prevent excessive electrocautery flow, and angulation to facilitate elevation of the papillary roof on cutting. A prospective series of patients with cholangitis or obstructive jaundice with failed biliary cannulation were recruited. The success of cannulation and complications following endoscopic retrograde cholangiopancreatography were analyzed. A total of 13 patients underwent precut sphincterotomy using the insulated angulotome. The immediate success of gaining biliary access after failed cannulation was 100 %. The mean size of the common bile duct on ultrasonography was 8.1 mm. The mean time to achieve biliary cannulation was 9 minutes 4 seconds, and there was no perforation or bleeding. This case series showed that precut sphincterotomy with the insulated angulotome can be safely performed without major complications.
一种新设计的隔热弯头刀在一系列因常规方法胆管插管失败而需要预切开括约肌的患者中进行了评估。该新器械包括一个隔热的玻璃尖端，以防止电流过大，同时还具有角度设计，便于在切割时抬起乳头顶部。前瞻性系列研究了因胆管插管失败而患有胆管炎或阻塞性黄疸的患者。分析了经内镜逆行胰胆管造影术（ERCP）后的插管成功率和并发症。共有 13 名患者使用隔热弯头刀进行了预切开括约肌。在插管失败后，获得胆管通路的即时成功率为 100%。超声检查显示胆总管的平均直径为 8.1 毫米。达到胆管插管的平均时间为 9 分 4 秒，没有穿孔或出血。本病例系列研究表明，使用隔热弯头刀进行预切开括约肌可以安全进行，没有严重并发症。
