<s>
Biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
is	O
a	O
procedure	O
where	O
the	O
sphincter	O
of	O
Oddi	O
and	O
the	O
segment	O
of	O
the	O
common	O
bile	O
duct	O
where	O
it	O
enters	O
the	O
duodenum	O
are	O
cannulated	O
and	O
then	O
cut	O
with	O
a	O
sphincterotome	O
,	O
a	O
device	O
that	O
includes	O
a	O
wire	O
which	O
cuts	O
with	O
an	O
electric	O
current	O
(	O
electrocautery	O
)	O
.	O
</s>
<s>
In	O
addition	O
,	O
it	O
is	O
commonly	O
performed	O
during	O
an	O
endoscopic	B-Algorithm
retrograde	I-Algorithm
cholangiopancreatography	I-Algorithm
(	O
ERCP	B-Algorithm
)	O
,	O
and	O
it	O
may	O
be	O
used	O
for	O
facilitating	O
diagnostic	O
procedures	O
such	O
as	O
transpapillary	O
bile	O
duct	O
biopsy	O
,	O
papillary	O
tumor	O
biopsy	O
,	O
and	O
insertion	O
of	O
a	O
cholangioscope	O
.	O
</s>
<s>
Biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
allows	O
for	O
opening	O
of	O
the	O
sphincter	O
of	O
Oddi	O
,	O
allowing	O
stones	O
to	O
be	O
removed	O
.	O
</s>
<s>
Biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
is	O
sometimes	O
used	O
,	O
with	O
or	O
without	O
stenting	O
,	O
to	O
relieve	O
the	O
obstruction	O
,	O
but	O
systematic	O
reviews	O
have	O
not	O
demonstrated	O
consistent	O
benefits	O
.	O
</s>
<s>
The	O
purpose	O
of	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
in	O
the	O
treatment	O
of	O
a	O
bile	O
leak	O
is	O
to	O
reduce	O
or	O
eliminate	O
the	O
pressure	O
gradient	O
between	O
the	O
bile	O
duct	O
and	O
the	O
duodenum	O
,	O
encouraging	O
transpapillary	O
bile	O
flow	O
and	O
allowing	O
the	O
leak	O
to	O
heal	O
.	O
</s>
<s>
Pre-cut	O
sphincterotomy	O
:	O
pre-cut	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
refers	O
to	O
the	O
techniques	O
used	O
to	O
cut	O
the	O
papillary	O
mucosa	O
and	O
biliary	O
sphincter	O
in	O
order	O
to	O
expose	O
the	O
underlying	O
bile	O
duct	O
and	O
gain	O
access	O
to	O
it	O
when	O
standard	O
cannulation	O
fails	O
.	O
</s>
<s>
The	O
rate	O
of	O
pancreatitis	O
after	O
ERCP	B-Algorithm
was	O
significantly	O
lower	O
after	O
fistulotomy	O
,	O
compared	O
to	O
other	O
precut	O
techniques	O
.	O
</s>
<s>
The	O
reported	O
overall	O
incidence	O
of	O
complications	O
associated	O
with	O
ERCP	B-Algorithm
and	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
has	O
ranged	O
from	O
3	O
to	O
12	O
percent	O
.	O
</s>
<s>
Pancreatitis	O
:	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
is	O
not	O
an	O
independent	O
risk	O
factor	O
for	O
pancreatitis	O
after	O
ERCP	B-Algorithm
.	O
</s>
<s>
Bleeding	O
:	O
immediate	O
bleeding	O
occurs	O
during	O
or	O
immediately	O
after	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
.	O
</s>
<s>
Cholangitis/sepsis	O
:	O
the	O
incidence	O
of	O
cholangitis	O
after	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
is	O
between	O
1%	O
and	O
3%	O
.	O
</s>
<s>
Late	O
complications	O
:	O
long-term	O
complication	O
vs	O
of	O
biliary	B-Algorithm
endoscopic	I-Algorithm
sphincterotomy	I-Algorithm
include	O
recurrent	O
common	O
bile	O
duct	O
stone	O
,	O
cholecystitis	O
,	O
cholangitis	O
,	O
hepatic	O
abscess	O
,	O
papillary	O
stenosis	O
and	O
biliary	O
stricture	O
.	O
</s>
