8 / 18
Page 22
Notes:
allied
academies
J Gastroenterol Dig Dis 2017 | Volume 2, Issue 3
World Gastroenterological &
Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada
World Congress on
Evaluating the combination of wire assisted cannulation and pure-cut sphincterotomy during
therapeutic endoscopic retrograde cholangiopancreatography: A prospective case series study
Fawzi H Obide
and
Hussam A Maiteeg
Misrata Centre of Gastroenterology and Hepatology, Libya
Introduction:
Post
Endoscopic
retrograde
cholangiopancreatography
pancreatitis
(PEP)
is
a
well-known complication of endoscopic retrograde
cholangiopancreatography (ERCP), ranging from biochemical
rise of amylase to severe fatal necrotising pancreatitis.
Since pancreatitis is a preventable complication, technical
optimisation at pre, intra and post procedural levels should
be carried out to reduce the risk. Trying to implement the
best approach to lower the risk of pancreatitis, combination
of wire assisted cannulation and pure-cut sphincterotomy
technique were adopted, since each of these techniques
is individually proven to be associated with lower risk of
pancreatitis.
Methods:
Prospective large case series study.
Results:
Over two years period, therapeutic ERCP was
performed for 311 patients (123 males and 188 females) for
various indications, patient ages ranging from 26-97 (males)
and 14-93 (female). PEP happened in 5 patients of the
entire number of patients (1.6%). Only 1 of them was male
(0.8%) while the other 4 patients were female 2.1%). Neither
perforation nor significant bleeding that required blood
transfusion or extension of hospitalisation has happened.
Discussion:
On one hand, there is a lot of debate regarding
the effectiveness of wire assisted technique as a preventing
measure in regards to PEP, on the other hand, few studies
used pure-cut sphincterotomy as preventive measure of
PEP. In both aspects as we notice, there is no clear cut-line
which method is better or is more effective. So we tried to
clarify or at least raise up a question, so further studies are
needed to investigate in separate taking in account that in
the current work both pancreatic stent and pharmacological
prophylactic measures were not used.
Conclusion:
Combination of wire assisted cannulation with
pure-cut sphincterotomy technique appears to be safe, cost
effective, with high success rate and low risk of PEP.
Speaker Biography
Fawzi H Obide is a consultant gastroenterologist in Misrata Centre of Gastroenterology
and Hepatology and is a Lecturer in Misrata Faculty of Medicine - Misrata University. He
received his training in Misrata Central Hospital and Tripoli Medical Centre governed by
the Libyan Board of Medical Specialties. He is playing a very active role in the field in
Libya. He is a trustee in the Libyan Society of Liver disease and in the Libyan Society of
Gastrointestinal endoscopy. He is the founder and the head manager of Misrata Centre
of Gastroenterology and Hepatology and is the founder of a medical company which
provides high quality medical services in gastroenterology. He is also a member of the
European Association of Study of Liver Disease (EASL) and the European Society of
Gasroentestinal Endoscopy (ESGE)
e:
Fawzi.obide@yahoo.com