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首页> 美国卫生研究院文献>Gastroenterology Research and Practice >A Novel Round Insulated Tip Papillotome as an Alternative to the Classic Needle-Knife for Precut Sphincterotomy in Endoscopic Retrograde Cholangiopancreatography
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A Novel Round Insulated Tip Papillotome as an Alternative to the Classic Needle-Knife for Precut Sphincterotomy in Endoscopic Retrograde Cholangiopancreatography

机译：一种新型的圆形绝缘尖端Papillotome替代内窥镜逆行胰胆管造影术中预切括约肌切开术的经典针刀

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Objective. The purpose of this study was to investigate the efficacy and safety of a new round insulated tip papillotome (r-ITP) as compared to that of the classic needle-knife sphincterotome (NKS) in difficult-to-cannulate endoscopic retrograde cholangiopancreatography (ERCP) patients. Materials and Methods. Patients with no exclusion criteria and an intact papilla referred for ERCP were invited to participate in the study. “Difficult-to-cannulate” patients, defined as failure to achieve deep biliary cannulation within five minutes from the first touch of papilla, with no more than ten attempts permitted, were randomly assigned for precut sphincterotomy using either the classic NKS or r-ITP. Results. Seventy and 69 patients were randomly assigned to the NKS and r-ITP groups, respectively. The groups were comparable regarding age, sex, indications, and associated conditions. There was no statistically significant difference in terms of successful cannulation or post-ERCP complications between the two groups. Only five patients (3.6%) developed mild to moderate post-ERCP pancreatitis and two had mild bleeding. No perforations or deaths were encountered. Conclusions. Although the round insulated tip papillotome was not shown to be superior to the classic NKS concerning efficacy and safety when used by an experienced endoscopist, it remains a simple, safe, and efficacious alternative.
机译：目的。这项研究的目的是研究与传统的针刀括约肌切开术（NKS）相比，新的圆形绝缘乳头刀（r-ITP）在难于插管的内镜逆行胰胆管造影（ERCP）中的疗效和安全性耐心。材料和方法。没有排除标准且完整乳头状体转诊ERCP的患者被邀请参加研究。 “难于插管”的患者定义为第一次接触乳头后五分钟内未能实现深胆管插管，且尝试次数不超过十次，被随机分配为使用经典的NKS或r-ITP进行预括约肌切开术。结果。分别将70例和69例患者随机分为NKS组和r-ITP组。这些组在年龄，性别，适应症和相关状况方面具有可比性。两组在成功插管或术后ERCP并发症方面无统计学差异。只有5例（3.6％）患者在ERCP后发展为轻度至中度胰腺炎，其中2例患有轻度出血。没有遇到穿孔或死亡。结论。尽管经验丰富的内镜医师未发现圆形绝缘尖端乳头刀在功效和安全性方面优于经典的NKS，但它仍然是一种简单，安全且有效的替代方法。

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