CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(07): E797-E800
DOI: 10.1055/a-0624-2288
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic management of difficult benign biliary and pancreatic strictures using a wire-guided cystotome: experience with 25 cases

Rajesh Puri
Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurugram, India
,
Sumit Bhatia
Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurugram, India
,
Rinkesh K. Bansal
Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurugram, India
,
Randhir Sud
Institute of Digestive and Hepatobiliary Sciences, Medanta The Medicity, Gurugram, India
› Author Affiliations
Further Information

Publication History

submitted 21 February 2018

accepted after revision 25 April 2018

Publication Date:
04 July 2018 (online)

Abstract

Background and study aims Endoscopic management using standard accessories is the preferred modality for treatment of benign biliary strictures. However, with difficult strictures, there is frequently failure of endoscopic therapy. We are reporting our experience regarding use of a standard diathermic dilator (cystotome) to aid in stricture dilatation and stent placement in patients with difficult strictures.

Patients and methods Data were analyzed from January 2014 to January 2017 at a single tertiary care center in North India. Total 25 patients were included.

Results The mean age was 45 years (varying from 38 – 55 years). Of the 25 patients with difficult strictures, 14 (56 %) were male and 11 (44 %) were female. Further, of these, 19 had biliary and 6 had pancreatic strictures. The average time of diathermic current application was 3.5 seconds (ranging 3 – 5 seconds). Technical and clinical success were achieved in 100 % of cases. None of the patients had any procedure-related (early or delayed) major complications.

Conclusion The cystotome is an extremely safe and useful accessory in benign biliary and pancreatic strictures, whereas conventional methods to negotiate stricture have failed.