Realización de precorte y colangiopancreatografía retrógrada endoscópica en segunda intención en acceso difícil a la vía biliar

Introduction. Precut needle-knife sphincterotomy for therapeutic ERCP have risk of complication. Objective. The aims of this study were to determinate the efficacy and safety of precut sphincterotomy and to identify risk factors and complications in ERCP. Material and methods. A total of 61/414 consecutive patients underwent precut sphincterotomy between January 2005 and May 2012. Medical records and patient data were prolective reviewed and included procedure indication, outcomes and complications. We used multivariate logistic regression analysis. Results. A total of 61/414 (14.73%) patients were included in the analysis (mean age was 59.6 years; 32 women) underwent sphincterotomy. There was no mortality. The success rates of prompt bile duct access after precut sphinterotomy were 95%. The complications rate was hemorrhage (3.3%) and pancreatitis (1.6%). Conclusion. A second ERCP after failure of initial biliary cannulation following precut appears to be safe and effective. A second ERCP should be delayed at least 8 days if feasible.