Đánh giá hiệu quả và tính an toàn của kỹ thuật cắt trước cơ vòng Oddi trong nội soi mật tụy ngược dòng ở bệnh nhân thông nhú đường mật khó

Abstract

Objective: To evaluate the characteristics of the effects, and complications of precut sphincterotomy for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography. Subject and method: A descriptive study conducted with 110 patients who had performed precut sphincterotomy for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography at 108 Military Central from January 2021 to May 2023. Result: A total of 110 patients (average age 66.9 ± 15.6, female 32.73%) with difficult biliary cannulation required precut sphincterotomy had previous operation with Billroth II gastrectomy and hepatopancreatic biliary surgery had 5.4% and 22.7%, respectively. The rate of diagnoses with the stones bile duct, malignant jaundice, and others had 47.3%; 36.4%, and 16.4%, respectively. Precut sphincterotomy with needle-knife fistulotomy, needle-knife precut sphincterotomy, and trans pancreatic sphincterotomy recorded 86.4%, 6,4%, and 7.3%. The precutting procedure was successful with 89.1%. The complication rate was 19.19% (21 of 110) (bleeding 4.5%, pancreatitis 9.1%, and cholangitis 5.5%, perforation 0%). Conclusion: Precut sphincterotomy for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography resulted in a high success and safety.