This journal is
indexed in Scopus
Year 2012 Vol. 20 No 5
EXCHANGE OF EXPERIENCE
EFFICIENCY OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND PAPILLOSPHINCTEROTOMY AT TREATMENT OF BILIARY SYSTEM DISEASES
Military Hospital, the State Border Service of AR, Baku
The Republic of Azerbaijan
Objectives. To evaluate the efficiency of the endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy at treatment of the biliary system diseases.
Methods. During the period from 2006 to 2011, 175 endoscopic retrograde cholan-giopancreatographies (ERCP) and 159 endoscopic papillosphincterotomies (EPST) were performed. All kinds of papillotomy were used: cannulation (complete, incomplete), needle (pre-cut, fistulotomy).
Results. The effectiveness of ERCP composed 92,7%. When it was impossible to carry out cannulation of Vater papilla and to reach the biliary system without trauma, we used needle or incomplete pre-cut papillotomy. Complication rate made up 8,9%. The highest percentage of complications was observed during the operation of EP-pre-cut (16,7%) with the needle electrode providing access to the common bile duct in the process the hindered cannulation. In 12 cases of the failed bile duct cannulation we managed to achieve positive results using a needle electrode.
Conclusions. The result analysis of the endoscopic procedures effectiveness indicates a high resolution capability of ERCP method (96,5%), and it is the «gold standard» at treatment of extrahepatic pathologies. Endoscopic papillotomy has high effectiveness amounting to 98,7%.
1. Nichitailo ME, Grubnik VV. Minimal'noinvazivnaia khirurgiia patologii zhelchnykh protokov [Miniinvasive surgery of biliary pathology]. Kiev, Ukraina: Zdorov'e; 2005. 424 p.
2. Adler DG, Baron TH, Davila RE, Egan J, Hirota WK, Leighton JA, Qureshi W, Rajan E, Zuckerman MJ, Fanelli R, Wheeler-Harbaugh J, Faigel DO. Standards of Practice Committee of American Society for Gastrointestinal Endoscopy. ASGE guideline: the role of ERCP in diseases of the biliary tract and the pancreas. Gastrointest Endosc. 2005 Jul;62(1):1–8.
3. Egiev VN, Valetov AI, Rudakova MN, Meshkov VM. K vyboru taktiki lecheniia kholedokholitiaza [Some aspects of treatment choice of choledocholithiasis]. Endoskop Khirurgiia. 2000;(6):13–15.
4. Ermakov EA, Lishchenko AN. Miniinvazivnye metody lecheniia zhelchnokamennoi bolezni, oslozhnennoi na-rusheniem prokhodimosti zhelchnykh protokov [Miniinvasive treatment of cholelithiasis complicated by bile duct obstruction]. [Khirurgiia Zhurn im NI Pirogova. 2003;(6):68–74.
5. Masci E, Toti G, Mariani A, Curioni S, Lomazzi A, Dinelli M, Minoli G, Crosta C, Comin U, Fertitta A, Prada A, Passoni GR, Testoni PA. Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001 Feb;96(2):417–23.
6. 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. Needle-knife papillotomy: a safe and effective technique in experienced hands. Hepatogastroenterology. 2004 Mar-Apr;51(56):349–52.
7. Linder S, Soderlund C. Factors influencing the use of precut technique at endoscopic sphincterotomy. Hepatogastroenterology. 2007 Dec;54(80):2192–97.
8. Gal'perina EI, Vetsheva PS, red. Rukovodstvo po khi-rurgii zhelchnykh putei. Moscow, RF: Vidar; 2009. 560 p.
9. Mallery JS, Baron TH, Dominitz JA, Goldstein JL, Hirota WK, Jacobson BC, Leighton JA, Raddawi HM, Varg JJ 2nd, Waring JP, Fanelli RD, Wheeler-Harbough J, Eisen GM, Faigel DO. Complications of ERCP. Gastrointest Endosc. 2003 May;57(6):633–38.
AZ 1072, Respublika Azerbaydzhan, g. Baku, Narimanovskiy r-n, ul. Fatali Han Hoyski 99, Voennyiy gospital, gosudarstvennaya pogranichnaya sluzhba AR,
Yusif-zade Kenan Rafael oglyi
Yusif-Zade K.R. Candidate of Medical Sciences, Chief of the Military Hospital of the State Border Service of Azerbaijan.