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Needle-knife sphincterotomy.

P Katsinelos¹, S Dimiropoulos, I Galanis

¹Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, TT 54635 Thessaloniki, Greece. pantso@the.forthnet.gr

Surgical Endoscopy

|October 26, 2002

Summary

Needle-knife sphincterotomy offers a safe and effective endoscopic treatment for large choledochoceles (choledochal cyst type III), resolving pancreatitis and obstructive cholestasis in adult patients.

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Area of Science:

Gastroenterology and Hepatology
Surgical Innovation

Background:

Choledochocele, a rare biliary anomaly (choledochal cyst type III), traditionally treated surgically, can cause abdominal pain, pancreatitis, and obstructive cholestasis.
Endoscopic therapy is emerging as an alternative treatment for choledochoceles, particularly in adult populations.

Observation:

Two adult patients presented with recurrent acute pancreatitis due to large choledochoceles.
Both patients underwent successful treatment with needle-knife sphincterotomy.

Findings:

The needle-knife sphincterotomy procedure was performed accurately and safely in both cases, despite the potential for increased bleeding risk with larger choledochoceles.
Patients remained asymptomatic during 1 and 2-year follow-ups, indicating successful resolution of the condition.

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Implications:

Needle-knife sphincterotomy presents a viable and safe endoscopic alternative to surgery for managing large choledochoceles.
Further research is warranted to confirm the long-term safety and efficacy of this technique for choledochal cyst type III.