Needle Knife Sphincterotomy - the Chris Hani Baragwanath Academic Hospital Experience
Thomson, J.T.; Smith, M.D.; Omoshoro-Jones, J.A.O.; Devar, J.D.; Khan, Z.K.; Jugmohan, B.J.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie 55(2): 53
2017
ISSN/ISBN: 0038-2361 PMID: 28876647 Document Number: 692711
Deep biliary cannulation is essential in performing a therapeutic ERCP. Cannulation can be enhanced through the utilization of a pre-cut by means of a needle knife sphincterotomy. Retrospective analysis of the Chris Hani Baragwanath Academic Hospital's ERCP database was performed. All ERCPs performed with the aid of a needle knife were identified and analysed for successful and unsuccessful deep biliary cannulation. 2830 ERCPs were performed during the study period. 369 (13%) required needle knife sphincterotomies and successful deep biliary cannulation was achieved in 229 (62%) of these patients. Repeat ERCPs were performed on 125 (34%) patients. 61 (49%) of the repeat ERCPs were performed because of previously failed cannulation. 34 (56%) of these repeat ERCPs resulted in successful deep biliary cannulation at re-attempt. 99% of successful cannulations at repeat ERCP had had a needle knife sphincterotomy at the first ERCP. Needle knife sphincterotomy improves deep biliary cannulation at initial ERCP and subsequent ERCPs with low incidences of complications.