Brief Article
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World J Gastroenterol. Oct 28, 2010; 16(40): 5077-5083
Published online Oct 28, 2010. doi: 10.3748/wjg.v16.i40.5077
Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding
Panagiotis Katsinelos, George Paroutoglou, Jannis Kountouras, Grigoris Chatzimavroudis, Christos Zavos, Sotiris Terzoudis, Taxiarchis Katsinelos, Kostas Fasoulas, George Gelas, George Tzovaras, Ioannis Pilpilidis
Panagiotis Katsinelos, Grigoris Chatzimavroudis, Sotiris Terzoudis, Taxiarchis Katsinelos, Kostas Fasoulas, Ioannis Pilpilidis, Department of Endoscopy and Motility Unit, Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, 54635 Thessaloniki, Greece
George Paroutoglou, George Gelas, George Tzovaras, Department of Gastroenterology, University Hospital of Thessaly, 41222 Larissa, Greece
Jannis Kountouras, Christos Zavos, 2nd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, 54642 Thessaloniki, Greece
Author contributions: Katsinelos P and Paroutoglou G performed the endoscopies; Chatzimavroudis G, Terzoudis S, Katsinelos T, Fasoulas K, Gelas G, Tzovaras G and Pilpilidis I analyzed and interpreted the patient data and reviewed the relative literature; Chatzimavroudis G performed the statistical analysis; Katsinelos P designed the study and wrote the manuscript; Zavos C and Kountouras J were major contributors in revising the manuscript critically for important intellectual content.
Correspondence to: Dr. Panagiotis Katsinelos, Assistant Professor, Head, Department of Endoscopy and Motility Unit, Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, 54635 Thessaloniki, Greece. gchatzim@med.auth.gr
Telephone: +30-2310-211221 Fax: +30-2310-210401
Received: April 19, 2010
Revised: June 25, 2010
Accepted: July 2, 2010
Published online: October 28, 2010
Abstract

AIM: To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Keywords: Sphincterotome, Endoscopic sphincterotomy, Hemorrhage, Complications