A retrospective analysis to assess the importance of doing a biliary sphincterotomy as a method to increase and simplify cannulation success rate of the main pancreatic duct.

This article, published in the journal Endoscopy, presents a retrospective analysis of pancreatic ERCP procedures conducted between October 2008 and May 2023. The study aimed to assess the effectiveness of biliary sphincterotomy in increasing the success rate of cannulating the main pancreatic duct (MPD). The results showed that when direct MPD cannulation was difficult, cannulating the common bile duct (CBD) first and performing a biliary sphincterotomy significantly improved the success rate of MPD cannulation, from 81.4% to 92.9%. Additionally, it was found that 71.4% of failed MPD cannulations after biliary sphincterotomy were due to undetected pancreas divisum. Patients who could not be cannulated at all were then subjected to EUS guided drainage or surgery. [Extracted from the article]