1989 Volume 31 Issue 2 Pages 417-421_1
The clinical importance of endoscopic sphincterotomy (EST) is increasing not only in treatment but also in diagnosis. We developed a new papillotomy knife with a channel for guidewire (P-GC, FUJITA; Figure 1). The method of performing EST with this knife is as follows (Figure 2): 1) selective cannulation beyond the papilla of Vater into the bile duct using an ordinary catheter about 6 French in size for endoscopic retrograde cholangiopancreatography (ERCP), 2) insertion of the guidewire into the intrahepatic duct through the catheter, 3) removal of only the catheter, 4) insertion of the P-GC into the bile duct over the guidewire, 5) removal of the guidewire only, 6) performance of EST. So, once deep cannulation into the bile duct is achieved using an ordinary catheter for FRCP, an endoscopist can accomplish EST with assurance and safety. We could successfully perform EST in 15 cases with this knife and never experienced any sequelae. Stability of suitable direction of the blade toward the, oral protrusion, another characteristic of P-GC, FUJITA, also contributed to the good results. P-GC will be of great help for endoscopists when performing EST.
