Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present such a case where the diagnosis was proven postoperatively. Our patient, a 51-ye...

A 24-year-old pregnant patient was referred to us because of pain and tenderness in the right upper quadrant. Her liver enzymes and bilirubin levels were elevated; an abdominal ultrasound examination revealed gallstones within the gallbladder. Diagnosis of biliary pancreatitis was established based on elevated amylase levels. Oral intake was withheld; intravenous antibiotic therapy and total pa...

IMPORTANCE Abdominal pain after cholecystectomy is common and may be attributed to sphincter of Oddi dysfunction. Management often involves endoscopic retrograde cholangiopancreatography (ERCP) with manometry and sphincterotomy. OBJECTIVE To determine whether endoscopic sphincterotomy reduces pain and whether sphincter manometric pressure is predictive of pain relief. DESIGN, SETTING, AND P...

Selective biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP) is required to perform all therapeutic biliary procedures. Despite major advances in imaging, guidewires and sphincterotome catheter designs, the success rate for biliary cannulation by experienced endoscopists during ERCP is approximately 85% when standard cannulation techniques are applied. Precut sphin...

BACKGROUND Some of patients with an intact gall bladder develop acute cholecystitis or have gall bladder stone formation after endoscopic sphincterotomy. Endoscopic sphincterotomy may affect gall bladder motility. AIMS To prospectively evaluate longterm effect of endoscopic sphincterotomy on gall bladder motility. PATIENTS Thirty two patients with an intact gall bladder (15 with and 17 with...

J.P. Neoptolemos, D.L. Carr-Locke and D.P. Fossard. (1987) Prospective randomised study of preoperative endoscopic sphincterotomy versus surgery alone for common bile duct stones. British Medical Journal, 294,470-474. One hundred and twenty patients with known common bile duct stones were entered into a prospective randomised study of preoperative endoscopic sphincterotomy and stone clearance (...

Postcholecystectomy pain caused by sphincter of Oddi dysfunction remains a difficult condition to treat. Endoscopic sphincterotomy has been recommended for those patients with confirmed sphincter of Oddi motor abnormalities. We have studied sphincter of Oddi dysfunction patients to evaluate the effects of endoscopic sphincterotomy on both clinical symptoms and previously reported scintigraphic ...

Sphincterotomy of the ampulla of Vater--a common diagnostic and therapeutic procedure that is sometimes done during endoscopic retrograde cholangiography (ERC)--allows reflux of intestinal content into the biliary tree. The resulting inflammation may contribute to malignant transformation of the biliary epithelium and therefore increase the risk of cholangiocarcinoma. We used data from populati...

OBJECTIVES To evaluate the efficacy, complications and outcomes of sphincterotomy with bladder neck incision in patients with voiding dysfunction (VD). METHODS We evaluated our prospectively established urologic urodynamic database and identified the records of 30 male patients with VD that underwent sphincterotomy between Octuber 1993 and December 2008. The IPSS and urodynamics were analyze...

OBJECTIVES This study aimed to evaluate whether synthetic secretin is effective in reducing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. METHODS This is a single academic medical center, prospective, randomized, double-blind, placebo-controlled trial using secretin (dose of 16 μg) administered intravenously immediately before ERCP. Patients were evaluated for the p...