Biliary Cannulation During Endoscopic Retrograde Cholangiopancreatography: Precut Versus Conventional Cannulation
Biliary Cannulation During Endoscopic Retrograde Cholangiopancreatography: Precut Versus Conventional Cannulation
Endoscopic sphincterotomy is now an established method for removal of common bile duct
 calculi and treatment of papillary stenosis, the sump syndrome and certain cases of ampullary
 carcinoma. It is also generally performed prior to biliary stent placement .Anatomical
 variations, papillary stenosis, impacted stones, ampullary tumors, duodenal diverticula, and
 post-gastrojejunostomy states are some of the reasons behind difficult common bile duct (CBD)
 cannulations . In these situations, the success of CBD cannulation can be enhanced slightly
 by using the various accessories designed for this purpose.The aim of this study is to
 prospectively compare conventional approach and needle knife fistulotomy in cannulation of
 ampulla of Vater during endoscopic retrograde cholangiopancreatography regarding
 procedure-related complications as failure of cannulations, bleeding and perforation and
 postoperative complication
The aim of this study is to prospectively compare conventional approach and needle knife
 fistulotomy in cannulation of ampulla of Vater during endoscopic retrograde
 cholangiopancreatography regarding procedure-related complications as failure of
 cannulations, bleeding and perforation and postoperative complication This a prospective
 randomized controlled trial comparing two groups of patients who undergo endoscopic
 retrograde cholangiopancreatography for obstructive jaundice in Gastrointestinal Surgical
 center, Mansoura University, Egypt. From January 2014 to December 2014.

 Group A consists of 50 patients who will undergo conventional approach and group B consists
 of 50 patients who undergo needle knife fistulotomy for cannulation of the ampulla of Vater.
 Randomization was done by paramedical personnel in the ERCP unit by taking a number from an
 envelope.

 Data will be registered in a specially prepared sheet for the purpose of the study.
 Registered data will include: duration of cannulation, number of trials for cannulation,
 number of pancreatic cannulation, bleeding during cannulation and its management, need to
 convert to the other approach in cannulation.

 Data also included postoperative hospital stay, serum amylase level and postoperative
 complications as pancreatitis, perforation, bleeding and cholecystitis. Pancreatitis will be
 also graded according to its severity depending on the duration of hospital stay.
Inclusion Criteria:

 -  all patients (no limit of age) required ERCP calculator and malignant obstructive
 jaundice

 Exclusion Criteria:

 -  unfit patients history of gastrectomy bleeding tendency larg tumour infiltrating the
 duodenum