Endoscopic Sphincterotomy vs. Balloon Dilation for Assessment of Pancreatitis
Endoscopic Sphincterotomy vs. Balloon Dilation for Assessment of Pancreatitis
One of the major elements of successful endoscopic retrograde cholangiopancreatography (
 ERCP) is the timely and uncomplicated cannulation of the common bile duct (CBD) . Various
 factors may adversely affect the cannulation procedure of the CBD leading to complications
 (acute pancreatitis after ERCP, perforation of the duodenum , bleeding ). Endoscopic
 sphincterotomy is frequently required for interventional procedures (eg stone extraction).
 During sphincterotomy, incision of the orifice of the papilla will be performed by using a
 sphincterotome. Complications due to sphincterotomy are known: Bleeding, increased rates of
 acute pancreatitis, small bowel perforation and scarring with consecutive stenosis of the
 papilla. As an alternative to sphincterotomy, balloon dilatation using balloon catheters can
 be performed. As a result, bleeding complications and scarring as late effects might be
 prevented. Current data is limited in terms of the risk of acute pancreatitis after ERCP when
 using a balloon catheter.

 This study aims to evaluate the incidence of acute pancreatitis and other complications after
 ERCP. Balloon dilatation of the papilla will be prospectively compared with endoscopic
 sphincterotomy in a randomized multicenter setting.
Inclusion Criteria:

 -  independent indication for ERCP

 -  age ≥ 18 years

 -  patient is able to understand informed consent

 Exclusion Criteria:

 -  S/p sphincterotomy

 -  pancreatic or CBD-stent in situ

 -  pregnant patient

 -  known chronic pancreatitis

 -  acute pancreatitis prior to intervention