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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2018; 6(16): 1073-1086
Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1073
Biliary endoscopic sphincterotomy: Techniques and complications
Aydın Şeref Köksal, Ahmet Tarik Eminler, Erkan Parlak
Aydın Şeref Köksal, Ahmet Tarik Eminler, Department of Gastroenterology, Sakarya University, School of Medicine, Sakarya 54290, Turkey
Erkan Parlak, Department of Gastroenterology, Hacettepe University, School of Medicine, Ankara 41000, Turkey
Author contributions: Köksal AS wrote the paper; Eminler AT collected materials and revised the article; Parlak E revised th article.
Conflict-of-interest statement: Authors declare no conflict of interests fort his review
Open-Access: This article is an open-access article which was selected byan in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Aydın Şeref Köksal, MD, Professor, Department of Gastroenterology, Sakarya University, School of Medicine, Korucuk Kampus, Sakarya 54290, Turkey. akoksal@sakarya.edu.tr
Telephone: +90-264-2552110
Received: September 26, 2018
Peer-review started: September 28, 2018
First decision: October 18, 2018
Revised: October 20, 2018
Accepted: November 23, 2018
Article in press: November 26, 2018
Published online: December 26, 2018
Processing time: 89 Days and 16.5 Hours
Abstract

Biliary endoscopic sphincterotomy (EST) refers to the cutting of the biliary sphincter and intraduodenal segment of the common bile duct following selective cannulation, using a high frequency current applied with a special knife, sphincterotome, inserted into the papilla. EST is either used solely for the treatment of diseases of the papilla of Vater, such as sphincter of Oddi dysfunction or to facilitate subsequent therapeutic biliary interventions, such as stone extraction, stenting, etc. It is a prerequisite for biliary interventions, thus every practitioner who performs endoscopic retrograde cholangiopancreatography needs to know different techniques and the clinical and anatomic parameters related to the efficacy and safety of the procedure. In this manuscript, we will review the indications, contraindications and techniques of biliary EST and the management of its complications.

Keywords: Complication; Indication; Biliary endoscopic sphincterotomy; Endoscopic retrograde cholangiopancreatography

Core tip: Biliary endoscopic sphincterotomy (EST) is an essential procedure of the endoscopic retrograde cholangiopancreatography (ERCP) for the treatment and palliation of a wide spectrum of biliary and papillary diseases. It has some contraindications and complications. The physicians who interested in ERCP must learn the equipments, techniques and the management of the complications of biliary EST. We herein widely review the indications, contraindications and techniques of biliary EST and the management of its complications.