Abstract

Background
/Aims: Endoscopic biliary sphincterotomy (EST) has a very important role in the treatment of pancreatico- biliary diseases, but it has complications. We retrospectively investigated whether the types of electrosurgical currents affect occurence of complications. Methods: In pancreatico- biliary diseases, consecutive 150 patients undergoing EST with pure cutting current (cutting group) and then consecutive 150 patient with blend current (blended group) were studied in respect to post-EST complications and the presence of periampullary diverticulum and papillitis in major papilla. Major bleeding was defined as a decrease in hemoglobin of at least 2 g/dL. Clinical pancreatitis was defined as abdominal pain with elevated serum amylase above three times about the upper normal limit after 48 hour. Results: Major bleeding has not occurred. Minor bleeding occurred in 25/300 patients (8.3%), but was not different in cutting group (n=150) and blended group (n=150). Except 54 patients with elevated amylase before procedure, pancreatitis occurred in 13/246 patients (5.3%), but was not different in cutting group (n=122) and blended group (n=124). Two cases in blended group had moderate pancreatitis. There was no differences of bleeding, pancreatitis, in patients with diverticulum (n=112) and without diverticulum (n=188). Minor bleeding was more common in patients with papillitis (n=24) than without papillitis (n=276) (p=0.000), but the incidence of post EST pancreatitis was similar. In 235 patients with choledocholithiasis, there was no difference in terms of bleeding, pancreatitis in cutting group (n=120) and blended group (n=115). Conclusions: Post- EST bleeding and pancreatitis were not affected by the types of electrosurgical current used. When EST was performed in patient with papillitis, minor bleeding was observed commonly. (Korean J Gastrointest Endosc 2004;28:298⁣306)

• Keywords: Endoscopic sphincterotomy, Electrosurgical current, Complication