BACKGROUND Anal fissure is a frequent proctologic disease. There are many and various treatments adopted to cure this disease. In this study we applied radiofrequencies to the subcutaneous lateral internal sphincterotomy and we compared the techniques in a randomised trial. METHODS Patients have been randomized in two groups: in group A 18 patients underwent subcutaneous lateral internal sphi...

Pancreas divisum has been postulated as a cause of acute pancreatitis and a chronic pain syndrome in a small subgroup of patients and can be treated with endoscopic dorsal pancreatic duct stent placement and minor papilla sphincterotomy. Twenty patients (9 with at least one attack of idiopathic pancreatitis, and 11 with severe pancreatic-type pain) were treated endoscopically. Dorsal duct stent...

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...

BACKGROUND The frequency of residual common bile duct (CBD) stones in patients with previous cholecystectomy ranges from 2-10%, and a minimally invasive approach is generally recommended for these patients. This study reviews the experience in the management of residual CBD stones at the Aga Khan University Hospital. METHODS All adult patients diagnosed to have residual CBD stones, from 1993 ...

BACKGROUND Post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common and most severe complication associated with diagnostic and therapeutic ERCP. A multivariate analysis of risk factors for PEP is essential for identifying patients at high risk and subsequently choosing other suitable diagnoses. METHODS Pertinent publications were identified through sy...

Editorial dealing with the protective action on biliary sphincterotomy complications given by type 2 diabetes mellitus.

History and definitions In 1681 Glisson described a sphincter at the end of the common bile duct, which allowed bile to flow intermittently into the duodenum.' Exactly 200 years later, Oddi portrayed the sphincteric mechanism in greater detail,2 but it was not until 1957 that Boyden unravelled the complexity ofthe anatomical sphincter surrounding the terminus of the common bile duct and pancrea...

context different approaches are routinely applied in the treatment of concomitant cholecystocholedocholithiasis. most patients are treated by preoperative endoscopic sphincterotomy followed by laparoscopic cholecystectomy in a two-stage approach. however one-stage approach carrying out intraoperative endoscopic sphincterotomy (ioes) is emerging as a minimally invasive alternative option. our r...