Comparison Of The Effect Of Isolated-Tip Knife And Needle Knife In ERCP Precut

Objective: By comparing the safety and the effectiveness of using Isolated-Tip Knife and needle knife to implement precut sphincterotomy assisted bile duct intubation in patients with difficult selective biliary cannulation,to explore the application prospect of Isolated-Tip Knife in precut sphincterotomy assisted bile duct.Methods: Eighty-three patients with common bile duct stones who had difficult selective biliary cannulation when receiving underwent endoscopic results retrograde cholangiopancreatography at the Endoscopic Center,and implement precut sphincterotomy assisted bile duct intubation in Qinhuangdao First Hospital from November 2019 to February 2023 were selected as the subjects study.The patients were divided into the IT group and the needle knife group according to the different application of the incision knife during the implementation of PST.There were 42 patients in the IT knife group;A total of 41 patients in needle knife group.General data(age,sex,clinical complications),preoperative and postoperative liver function related indicators(bilirubin,alanine aminotransferase,glutamyl transpeptidase,γ-aspartate transaminase),operation-related indicators(intubation time,intubation success rate)and ERCP-related complications(acute pancreatitis,hemorrhage,perforation and acute cholangitis)were statistically analyzed and compared with SPSS software.Results:1.The average intubation time in the IT knife group was(6.4 ± 1.2)min,and the average intubation time in the needle knife group was(5.9 ±1.4)min.The intubation time in the needle knife group was shorter than that in the IT knife group,but the difference was not statistically significant(P=0.118).The success rate of intubation in the IT knife group was 92.9%,the success rate of intubation in the needle knife group was 90.2%,and the success rate of intubation in the IT knife group was 1.9% higher than that in the needle knife group,but the difference was not statistically significant(P=0.973).2.There was no acute pancreatitis in the IT knife group.There were 6cases(14.6%)of acute pancreatitis in the needle knife group.The incidence of postoperative pancreatitis in the needle knife group was higher than that in the IT knife group.The difference between the two groups was statistically significant(P=0.032).There were 9 cases(21.4%)of intraoperative bleeding in the IT knife group and 8 cases(19.5%)in the needle knife group.The intraoperative bleeding rate in the IT knife group was higher than that in the needle knife group,but the difference between the two groups was not statistically significant(P=0.829).No postoperative hemorrhage,perforation and acute cholangitis occurred in both groups.Conclusion: The incidence of postoperative pancreatitis after PST-assisted bile duct intubation with IT knife is lower than that after PST-assisted bile duct intubation with needle knife,and there is no significant differences difference in intubation time,intubation success rate and other complications,The application of PST-assisted bile duct intubation with IT knife is worthy of clinical promotion.