久野木康仁先生の症例報告が、DEN open誌（Journal Citation Reports Impact Factor 2023 = 1.4）にacceptされました。

DEN Open. 2024 Oct 8;5(1):e70019. doi: 10.1002/deo2.70019. eCollection 2025 Apr.

All-in-one sphincterotome with high rotation performance and freely bendable blade for endoscopic sphincterotomy in patients with surgically altered anatomy (a case series with video)

Yasuhito Kunogi, Atsushi Irisawa, Akira Yamamiya, Manabu Ishikawa, Tomoya Sakamoto, Yasunori Inaba, Ken Kashima, Fumi Sakuma, Koh Fukushi, Takumi Maki, Kazunori Nagashima, Yoko Abe, Shuichi Kitada, Akane Yamabe, Keiichi Tominaga

Affiliations Expand
PMID: 39386274 PMCID: PMC11461899 DOI: 10.1002/deo2.70019

Abstract
A new type of sphincterotome released to the market recently has high rotation performance and a freely bendable blade. It is devised to be singly capable of accommodating not only normal anatomy but also cases with surgically altered anatomy. This study was undertaken for clinical evaluation of the usefulness of this new sphincterotome. Eight cases in a reconstructed intestine for which cannulation or endoscopic sphincterotomy (EST) had been performed were extracted from 32 cases for which endoscopic retrograde cholangiopancreatography-related procedures were performed using the sphincterotome developed during November 2023 through February 2024. The cases were investigated retrospectively. Among these, EST was applied to six cases. Cannulation was performed using the developed sphincterotome in the native papilla in four cases. The primary endpoints were the success rate of cannulation in surgically altered anatomy and the success rate of EST. Secondary endpoints were complications and usability for operators. Usability for operators was evaluated by questionnaire for several items on a 5-point scale. EST was conducted successfully in all six cases subjected to EST. Mild hemorrhage was observed in one case (17%) as an adverse event after EST. Deep cannulation to the native papilla with the developed sphincterotome was conducted successfully in three cases (75.0%). Evaluation results by operators were 4.4 ± 0.55 for rotation performance, 4.00 ± 0.63 for incision performance, 4.29 ± 0.49 for deep cannulation performance, and 4.07 ± 0.19 for overall evaluation. In conclusion, this developed sphincterotome might be very useful for EST and cannulation in cases with surgically altered anatomy.

Keywords: ERCP; endoscopic sphincterotomy; rotation; sphincterotome; surgically altered anatomy.

© 2024 The Author(s). DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.

https://pubmed.ncbi.nlm.nih.gov/39386274/