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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 14, 2007; 13(30): 4064-4071
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4064
Pancreatic sphincterotomy: Technique, indications, and complications
Jonathan M Buscaglia, Anthony N Kalloo
Jonathan M Buscaglia, Anthony N Kalloo, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Jonathan M Buscaglia, MD, Johns Hopkins Hospital, 1830 E. Monument Street, Room 7100-A, Baltimore, MD 21205, United States.
Telephone: +1-410-6146708 Fax: +1-410-9552108
Received: May 3, 2007
Revised: May 5, 2007
Accepted: May 28, 2007
Published online: August 14, 2007

Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically, its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a definite and useful role in diseases such as chronic pancreatitis and pancreatic-type sphincter of Oddi dysfunction. In the appropriate setting, it may be used as a single therapeutic maneuver, or in conjunction with other endoscopic techniques such as pancreatic stone extraction or stent placement. The current standard of practice utilizes two different methods of performing pancreatic sphincterotomy: a pull-type sphincterotome technique without prior stent placement, and a needle-knife sphincterotome technique over an existing stent. The complications associated with pancreatic sphincterotomy are many, although acute pancreatitis appears to be the most common and the most serious of the early complications. As such, it continues to be reserved for those endoscopists who perform a relatively high-volume of therapeutic pancreaticobiliary endoscopic retrograde cholangio-pancreatography.

Keywords: Pancreas, Sphincterotomy, Endoscopic, Technique, Indications, Complications