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KMID : 0614619920240061398
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Korean Journal of Gastroenterology
1992 Volume.24 No. 6 p.1398 ~ p.1402
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The Usefulness of Needle Knife Paipillotomy in the Diagnosis and Therapy of Biliary Disease
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김명환
이미호/이선영/정성훈/이성구/민영일
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Abstract
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Needle knife papillotomy was first introduced for impacted papillary stones. At present the use of needle knife papillotome has been extended to include attempted biliary access after failure of conventional techniques or initation of
sphincterotomy in
patients with Billroth II gastrectomy.
During 3 years, we performed endoscopic sphincterotomy with needle knife papillotome in 45 patients. The indication for the use of needle knife papillotome was periampullary tumor (n=10). papillary impacted stone (n=7). Billroth II gastrectomy
(n=6),
difficult cannulation with normalappearing papilla or papillitis (n=13). periampullary diverticula (n=4), for precut (n=4) and for biopsy (n=1).
Common bile duct access was successful after needle knife papillotomy in 40 (89%) out of 45 patients. Complications were duodenal perforation (n=2), cholangitis (n=2) and pancreatitis (n=1). and they were managed uccessfully by medical treatment.
In conclusion, it is thus clear that needle knife papillotomy is a helpful procedure with acceptable and not prohibitive risk. It may be used by experienced endoscopists only to increase the success rate of common bile duct access after failure
of
conventional method.
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KEYWORD
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