Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding

• Published in: World journal of gastroenterology : WJG Vol. 16; no. 40; pp. 5077 - 5083
• Main Authors: Katsinelos, Panagiotis, Paroutoglou, George, Kountouras, Jannis, Chatzimavroudis, Grigoris, Zavos, Christos, Terzoudis, Sotiris, Katsinelos, Taxiarchis, Fasoulas, Kostas, Gelas, George, Tzovaras, George, Pilpilidis, Ioannis
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 28-10-2010
• Subjects: Aged; Aged, 80 and over; Brief; Cholangiopancreatography, Endoscopic Retrograde; Choledocholithiasis - surgery; Female; Humans; Incidence; Male; Middle Aged; Outcome Assessment (Health Care); Pancreatic Neoplasms - surgery; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - etiology; Prospective Studies; Sphincterotomy, Endoscopic - adverse effects; Sphincterotomy, Endoscopic - methods; Treatment Outcome
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v16.i40.5077

To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications.
All patients referred for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) were randomly assigned to undergo ES either with a partially covered or an uncovered sphincterotome. Both patient and technical risk factors contributing to the development of post-ES bleeding were recorded and analyzed. The characteristics of bleeding was recorded during and after ES. Other complications were also compared.
Three-hundred and eighty-seven patients were recruited in this study; 194 patients underwent ES with a partially covered sphincterotome and 193 with conventional uncovered sphincterotome. No statistical difference was noted in the baseline characteristics and risk factors for post-ES induced hemorrhage between the 2 groups. No significant difference in the incidence and pattern of visible bleeding rates was found between the 2 groups (immediate bleeding in 24 patients with the partially covered sphincterotome vs 19 patients with the uncovered sphincterotome, P = 0.418). Delayed bleeding was observed in 2 patients with a partially covered sphincterotome and in 1 patient with an uncovered sphincterotome (P = 0.62). No statistical difference was noted in the rate of other complications.
The partially covered sphincterotome was not associated with a lower frequency of bleeding. Also, there was no difference in the incidence of other significant complications between the 2 types of sphincterotome.