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1

Park, S.-H., and TH Lee. "Precut Papillotomy with Isolated-Tip Needle-Knife Papillotome." Video Journal and Encyclopedia of GI Endoscopy 1, no. 2 (October 2013): 523–25. http://dx.doi.org/10.1016/s2212-0971(13)70229-2.

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2

Palm, Jukka, Arto Saarela, and Jyrki M??kel?? "Safety of Erlangen Precut Papillotomy." Journal of Clinical Gastroenterology 41, no. 5 (May 2007): 528–33. http://dx.doi.org/10.1097/mcg.0b013e31802b8728.

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3

Conio, Massimo, Sebastiano Saccomanno, Hugo Aste, and Vittorio Pugliese. "Precut papillotomy: primum non nocere." Gastrointestinal Endoscopy 36, no. 5 (September 1990): 544. http://dx.doi.org/10.1016/s0016-5107(90)71150-9.

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4

Wilcox, C. Mel, and Klaus F. Mönkemüller. "Wire-assisted minor papilla precut papillotomy." Gastrointestinal Endoscopy 54, no. 1 (July 2001): 83–86. http://dx.doi.org/10.1067/mge.2001.115474.

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5

Huibregtse, K., R. M. Katon, and G. N. J. Tytgat. "Precut papillotomy via fine-needle knife papillotome: a safe and effective technique." Gastrointestinal Endoscopy 32, no. 6 (December 1986): 403–5. http://dx.doi.org/10.1016/s0016-5107(86)71921-4.

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6

Miyatani, Hiroyuki, and Yukio Yoshida. "Endoscopic Needle Knife Precut Papillotomy for Inaccessible Bile Duct following Failed Pancreatic Duct Access." Clinical Medicine. Gastroenterology 2 (December 16, 2008): CGast.S1120. http://dx.doi.org/10.4137/cgast.s1120.

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Aims To evaluate the safety, effectiveness, success rate and complications of needle knife precut papillotomy for inaccessible bile duct after failed pancreatic ducts access. Methods Selective common bile duct cannulation was required for 582 patients from November 2004 to May 2008. Precut sphincterotomy was performed in 28 patients (16 male, 12 female; mean age 71). When standard bile duct cannulation was unsuccessful after more than 20 minutes, the bile duct was considered inaccessible. Group A consisted of patients where pancreatic duct access was possible and transpancreatic papillary septotomy was performed (20 patients). If pancreatic duct cannulation also failed, needle knife precut method was performed and these patients belonged to group B (8 patients). The success and complication rates of the two groups were compared using the Chi-square test. Results The success rates were 85% and 87.5% respectively. Of the 28 patients in group A, 6 had mild to moderate pancreatitis and one patient had mild bleeding. The complication rates were 35% and 0% respectively and the differences were not significant. Conclusion Needle knife precut papillotomy is useful and acceptable in patients after failed pancreatic duct access.
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7

Zimmon, DS. "Endoscopic sphincterotomy - The basics." Canadian Journal of Gastroenterology 4, no. 9 (1990): 559–63. http://dx.doi.org/10.1155/1990/691410.

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Endoscopic sphincterotomy refers to the incision of the terminal portion of the biliary or pancreatic ducts by a variety of techniques, depending on anatomic circumstances, goals and risks. Alternative methods include percutaneous transhepatic or surgical techniques. The initial Erlangen method - complete sphinccerotomy - carried an unavoidable risk of perforation and hemorrhage. Fractional incision or 'endoscopic papillotomy' - incision of the inferior sphincter - carries no risk of hemorrhage or perforation, done properly. Techniques of papillotomy including 'pull,' 'precut,' stent placement, infundibulotomy, percutaneous cholangiography, and internal spring wire are described, and general electrosurgical principles discussed.
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8

Liang, Yun-Xiao. "Needle-knife precut papillotomy for difficult biliary cannulation." World Chinese Journal of Digestology 22, no. 8 (2014): 1153. http://dx.doi.org/10.11569/wcjd.v22.i8.1153.

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9

Cárdenas, A., and G. Fernández-Esparrach. "Precut Papillotomy for Access into the Bile Duct." Video Journal and Encyclopedia of GI Endoscopy 1, no. 2 (October 2013): 520–22. http://dx.doi.org/10.1016/s2212-0971(13)70228-0.

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Cotton, Peter B. "Precut papillotomy—a risky technique for experts only." Gastrointestinal Endoscopy 35, no. 6 (November 1989): 578–79. http://dx.doi.org/10.1016/s0016-5107(89)72921-7.

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11

Park, Sang-Heum, Hyun-Jun Kim, Suck-Ho Lee, Hong-Joo Kim, Hong-Soo Kim, and Sun-Joo Kim. "Precut Papillotomy Using a New Sphincterotome (Iso-Tome)." Gastrointestinal Endoscopy 59, no. 5 (April 2004): P201. http://dx.doi.org/10.1016/s0016-5107(04)00929-0.

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12

Park, Sang-Heum, and Tae Hoon Lee. "Confrontational Strategy Is Essential for Being Effective Precut Papillotomy." Gut and Liver 9, no. 4 (July 23, 2015): 435. http://dx.doi.org/10.5009/gnl15203.

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13

AKIN, Hakan, Ebubekir Senates, Orhan Kocaman, Ahmet Danalioglu, Ali T. Ince, and Hakan Senturk. "824 Precut Papillotomy With the Iso-Tome Device Is an Alternative Method to the Needle-knife Precut Papillotomy Technique in ERCP Canulation." Gastrointestinal Endoscopy 79, no. 5 (May 2014): AB171. http://dx.doi.org/10.1016/j.gie.2014.02.182.

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14

Booth, Frank V. McL, Ralph J. Doerr, Reza S. Khalafi, Frederick A. Luchette, and Lewis M. Flint. "Surgical management of complications of endoscopic sphincterotomy with precut papillotomy." American Journal of Surgery 159, no. 1 (January 1990): 132–36. http://dx.doi.org/10.1016/s0002-9610(05)80618-x.

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15

Fukatsu, Hirotoshi, Hirofumi Kawamoto, Ryo Harada, Koichiro Tsutsumi, Masakuni Fujii, Hironari Kato, Ken Hirao, et al. "Quantitative assessment of technical proficiency in performing needle-knife precut papillotomy." Surgical Endoscopy 23, no. 9 (June 5, 2008): 2066–72. http://dx.doi.org/10.1007/s00464-008-9969-x.

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16

Chan, Ting-Ting, Marcus C. H. Chew, and Raymond S. Y. Tang. "Troubleshooting Difficult Bile Duct Access: Advanced ERCP Cannulation Techniques, Percutaneous Biliary Drainage, or EUS-Guided Rendezvous Technique?" Gastroenterology Insights 12, no. 4 (October 27, 2021): 405–22. http://dx.doi.org/10.3390/gastroent12040039.

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Despite experienced hands and availability of various well-designed catheters and wires, selective bile duct cannulation may still fail in 10–20% of cases during endoscopic retrograde cholangiopancreatography (ERCP). In case standard ERCP cannulation technique fails, salvage options include advanced ERCP cannulation techniques such as double-guidewire technique (DGW) with or without pancreatic stenting and precut papillotomy, percutaneous biliary drainage (PBD), and endoscopic ultrasound-guided Rendezvous (EUS-RV) ERCP. If the pancreatic duct is inadvertently entered during cannulation attempts, DGW technique is a reasonable next step, which can be followed by pancreatic stenting to reduce risks of post-ERCP pancreatitis (PEP). Studies suggest that early precut papillotomy is not associated with a higher risk of PEP, while needle-knife fistulotomy is the preferred method. For patients with critical clinical condition who may not be fit for endoscopy, surgically altered anatomy in which endoscopic biliary drainage is not feasible, and non-communicating multisegmental biliary obstruction, PBD has a unique role to provide successful biliary drainage efficiently in this particular population. As endoscopic ultrasound (EUS)-guided biliary drainage techniques advance, EUS-RV ERCP has been increasingly employed to guide bile duct access and cannulation with satisfactory clinical outcomes and is especially valuable for benign pathology at centres where expertise is available. Endoscopists should become familiar with each technique’s advantages and limitations before deciding the most appropriate treatment that is tailored to patient’s anatomy and clinical needs.
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Gotam Das, Prem Kumar, Muhammad Akram Bajwa, Sajan Sawai, Muneer Sadiq, and Shabnam Rani. "Predisposing Factors in Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 18, no. 2 (June 22, 2022): 126–31. http://dx.doi.org/10.48036/apims.v18i2.517.

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Objective: To ascertain the prevalence of risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography at Isra University Hospital in Hyderabad. Methodology: This descriptive case series study was done at the gastroenterology department of Isra University Hospital, Hyderabad, from September 2018 to March 2020. Patients aged 18 to 50 years, both genders, and diagnosed with post-ERCP pancreatitis were included. All the patients were undergoing an ERCP procedure. The procedure was done under conscious sedation or propofol where needed. The serum amylase level was assessed in all patients at 4 hours. Patients had been considered to have post-ERCP pancreatitis if they developed new or worsening pain of abdomen and had a threefold increase in serum amylase. All the cases were assessed regarding risk factors in pancreatitis after endoscopic retrograde cholangiopancreatography. All the data was recorded in the proforma. Results: The mean age of the patients was 42.7 years. The majority of the patients (65.47%) were females and 32.90% were males. The mean duration of pancreatitis was 3.1 days. Sphincter of Oddi dysfunction was found in 17.1% of cases. Precut papillotomy was done in 18(23.7%) cases. Repeated pancreatic duct injury was seen in 10(13.2%) cases. No significant difference was found in the effect of modifiers on predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis, p-values were almost insignificant. Conclusion: Cannulation attempts, Sphincter of Oddi dysfunction, precut papillotomy, repeated pancreatic duct injection, and female gender were observed to be the predisposing factors in post-endoscopic retrograde cholangiopancreatography pancreatitis.
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18

Marshall, John B., and William N. Stassen. "Multiquadrant precut papillotomy for extraction of large impacted common bile duct stone." Gastrointestinal Endoscopy 31, no. 5 (October 1985): 336–38. http://dx.doi.org/10.1016/s0016-5107(85)72219-5.

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19

Tang, S. J., G. B. Haber, P. Kortan, S. Zanati, M. Cirocco, M. Ennis, A. Elfant, D. Scheider, H. Ter, and J. Dorais. "Precut Papillotomy Versus Persistence in Difficult Biliary Cannulation: A Prospective Randomized Trial." Endoscopy 37, no. 1 (January 2005): 58–65. http://dx.doi.org/10.1055/s-2004-826077.

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20

Zhang, Qisheng, Bing Han, Jianhua Xu, Wenmin Bao, Jieli Tao, and Yun Zhang. "Needle Knife Precut Papillotomy and Fistulotomy for Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography." Digestion 88, no. 2 (2013): 95–100. http://dx.doi.org/10.1159/000352027.

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21

Varadarajulu, Shyam, and K. R. Palaniswamy. "Precut Papillotomy is Effective and Safe Only ???When??? Clinically Indicated and ???in??? Expert Hands." Journal of Clinical Gastroenterology 41, no. 5 (May 2007): 435–36. http://dx.doi.org/10.1097/mcg.0b013e31802c4c10.

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22

Dhir, Vinay, Suryaprakash Bhandari, Mukta Bapat, and Amit Maydeo. "Comparison of EUS-guided rendezvous and precut papillotomy techniques for biliary access (with videos)." Gastrointestinal Endoscopy 75, no. 2 (February 2012): 354–59. http://dx.doi.org/10.1016/j.gie.2011.07.075.

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23

Choudhary, Abhishek, Jessica Winn, Sameer Siddique, Alisha Hinds, Saket Kottewar, Murtaza Arif, and Matthew Bechtold. "Early Precut Biliary Papillotomy Prevents Post-ERCP Pancreatitis: A Systematic Review and Meta-analysis." American Journal of Gastroenterology 108 (October 2013): S81. http://dx.doi.org/10.14309/00000434-201310001-00264.

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24

Liu, Feng, Jianqiang Liu, and Zhaoshen Li. "New role of the dual knife for precut papillotomy in difficult bile duct cannulation." Digestive Endoscopy 25, no. 3 (July 27, 2012): 329–32. http://dx.doi.org/10.1111/j.1443-1661.2012.01358.x.

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Park, Sang-Heum, Do Hyun Park, Ho-Seong Lee, Yong-Sub Lee, Jeong-Hoon Park, Suck-Ho Lee, IL-Kwun Chung, Hong-Soo Kim, Hyo-Jin Lee, and Sun-Joo Kim. "Clinical Usefulness of the Mucosa-Tracking-Technique (MTT) with the Iso-Tome in Precut Papillotomy." Gastrointestinal Endoscopy 65, no. 5 (April 2007): AB216. http://dx.doi.org/10.1016/j.gie.2007.03.448.

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26

Mavrogiannis, Christos, Christos Liatsos, Andreas Romanos, Christos Petoumenos, Antonios Nakos, and Gerasimos Karvountzis. "Needle-knife fistulotomy versus needle-knife precut papillotomy for the treatment of common bile duct stones." Gastrointestinal Endoscopy 50, no. 3 (September 1999): 334–39. http://dx.doi.org/10.1053/ge.1999.v50.98593.

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27

Pécsi, Dániel, Nelli Farkas, Péter Hegyi, Márta Balaskó, József Czimmer, András Garami, Anita Illés, et al. "Transpancreatic sphincterotomy has a higher cannulation success rate than needle-knife precut papillotomy – a meta-analysis." Endoscopy 49, no. 09 (June 13, 2017): 874–87. http://dx.doi.org/10.1055/s-0043-111717.

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Abstract Background and aim While many studies have discussed the different cannulation techniques used in patients with difficult biliary access, no previous meta-analyses have compared transpancreatic sphincterotomy (TPS) to other advanced techniques. Therefore, we aimed to identify all studies comparing the efficacy and adverse event rates of TPS with needle-knife precut papillotomy (NKPP), the most commonly used technique, and to perform a meta-analysis. Methods The Embase, PubMed, and Cochrane databases were searched for trials comparing the outcomes of TPS with NKPP up till December 2016. A meta-analysis focusing on outcome (cannulation success, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), post-procedural bleeding, and total adverse events) was performed. The population, intervention, comparison, outcome (PICO) format was used to compare these cannulation approaches. Five prospective and eight retrospective studies were included in our meta-analysis. Results NKPP has a significantly lower success rate (odds ratio [OR] 0.50, P = 0.046; relative risk [RR] 0.92, P = 0.03) and a higher rate of bleeding complications (OR 2.24, P = 0.02; RR 2.18, P = 0.02) than TPS. However, no significant differences were found in PEP (OR 0.79, P = 0.24; RR 0.80, P = 0.19), perforation (risk difference [RD] 0.01, P = 0.23), or total complication rates (OR 1.22, P = 0.44; RR 1.17, P = 0.47). Conclusion While TPS has a higher success rate in difficult biliary access and causes less bleeding than NKPP, there are no differences in PEP, perforation, or total complication rates between the two approaches. We conclude that TPS, in the hands of expert endoscopists, is a safe procedure, which should be used more widely in patients with difficult biliary access.
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Guzmán-Calderón, Edson, Belen Martinez-Moreno, Juan A. Casellas, and José Ramón Aparicio. "Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation: a systematic review and meta-analysis." Endoscopy International Open 09, no. 11 (November 2021): E1758—E1767. http://dx.doi.org/10.1055/a-1534-2388.

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Abstract Background and study aims Approximately 11 % of biliary cannulations are considered difficult. The double guidewire (DGW-T) and transpancreatic sphincterotomy (TPS) are two useful techniques when difficult cannulation exists and the main pancreatic duct is unintentionally accessed. We carried out a systematic review and meta-analysis to evaluate the effectiveness and security of both DGW-T and TPS techniques in difficult biliary cannulation. Methods We conducted a systematic review in different databases, such as PubMed, OVID, Medline, and Cochrane Databases. Were included all RCT which showed a comparison between TPS and DGW in difficult biliary cannulation. Endpoints computed were successful cannulation rate, median cannulation time, and adverse events rate. Results Four studies were selected (4 RCTs). These studies included 260 patients. The mean age was 64.79 ± 12.99 years. Of the patients, 53.6 % were men and 46.4 % were women. The rate of successful cannulation was 93.3 % in the TPS group and 79.4 % in the DGW-T group (P = 0.420). The rate of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) was lower in patients who had undergone TPS than DGW-T (TPS: 8.9 % vs DGW-T: 22.2 %, P = 0.02). The mean cannulation time was 14.7 ± 9.4 min in the TPS group and 15.1 ± 7.4 min with DGW-T (P = 0.349). Conclusions TPS and DGW are two useful techniques in patients with difficult cannulation. They both have a high rate of successful cannulation; however, the PEP was higher with DGW-T than with TPS.
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Lee, Alexander, Anupam Aditi, Yasser Bhat, Kenneth Binmoeller, Chris Hamerski, Oriol Sendino, Steve Kane, et al. "Endoscopic ultrasound-guided biliary access versus precut papillotomy in patients with failed biliary cannulation: a retrospective study." Endoscopy 49, no. 02 (January 20, 2017): 146–53. http://dx.doi.org/10.1055/s-0042-120995.

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Subei, Iyad M., Mohsen Salama, and Salah Elderiny. "Pancreatic duct stenting prior to needle knife precut papillotomy provides a limited help a prospective randomized study." Gastrointestinal Endoscopy 43, no. 4 (April 1996): 397. http://dx.doi.org/10.1016/s0016-5107(96)80424-x.

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Fukatsu, Hirotoshi, Hirofumi Kawamoto, Hironari Kato, Ken Hirao, Naoko Kurihara, Takashi Nakanishi, Osamu Mizuno, et al. "Evaluation of needle-knife precut papillotomy after unsuccessful biliary cannulation, especially with regard to postoperative anatomic factors." Surgical Endoscopy 22, no. 3 (August 18, 2007): 717–23. http://dx.doi.org/10.1007/s00464-007-9473-8.

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Figueiredo, Fátima A. F., Alexandre Dias Pelosi, Lílian Machado, Ellen Francioni, Glaucia Freitas, Priscila Barbi Hatum, and Renata de Mello Perez. "Precut Papillotomy: A Risky Technique Not Only for Experts but Also for Average Endoscopists Skilled in ERCP." Digestive Diseases and Sciences 55, no. 5 (June 18, 2009): 1485–89. http://dx.doi.org/10.1007/s10620-009-0860-y.

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Matsubayashi, Hiroyuki, Shohei Ooka, Hirokazu Kimura, Hiroaki Sawai, Naomi Kakushima, Masaki Tanaka, Michael Goggins, and Hiroyuki Ono. "Proximally migrated pancreatic stent successfully removed using needle-knife and forceps: Complication after precut papillotomy assisted by pancreatic stenting." Clinics and Research in Hepatology and Gastroenterology 35, no. 4 (April 2011): 321–24. http://dx.doi.org/10.1016/j.clinre.2010.12.003.

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Chotiprasidhi, Poonputt, Gail Robuck-Mangum, Malcolm S. Branch, Paul S. Jowell, Katrina L. Swartz, and John Baillie. "4618 Precut papillotomy has a low complication rate in experienced hands: a 6-year retrospective review from a specialist center." Gastrointestinal Endoscopy 51, no. 4 (April 2000): AB185. http://dx.doi.org/10.1016/s0016-5107(00)14465-7.

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Zheng, Mingwei, Xufeng Liu, Ning Li, and Wei-Zhi Li. "Emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla." Digestive and Liver Disease 50, no. 3 (March 2018): 267–70. http://dx.doi.org/10.1016/j.dld.2017.11.015.

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Park, Sang-Heum, Do Hyun Park, Tae Hoon Lee, Ho-Sung Lee, Yong-Sub Lee, Sae Hwan Lee, Chang Kyun Lee, et al. "Feasibility of the Mucosa-Tracking Technique in Precut Papillotomy with the Iso-Tome as an Alternative to the Needle-Knife Technique." Gut and Liver 4, no. 1 (March 30, 2010): 76–83. http://dx.doi.org/10.5009/gnl.2010.4.1.76.

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Kim, Tae Nyeun, and Si Hyung Lee. "Endoscopic Papillary Large Balloon Dilation Combined with Guidewire-Assisted Precut Papillotomy for the Treatment of Choledocholithiasis in Patients with Billroth II Gastrectomy." Gut and Liver 5, no. 2 (June 30, 2011): 200–203. http://dx.doi.org/10.5009/gnl.2011.5.2.200.

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Sato, Takamitsu, Seitaro Watanabe, Kunihiro Hosono, Noritoshi Kobayashi, Atsushi Nakajima, and Kensuke Kubota. "Mo1285 Needle-Knife Precut Papillotomy With a Small Incision Over a Pancreatic Stent Improves the Success and Complication Rates in Difficult Biliary Cannulation." Gastrointestinal Endoscopy 75, no. 4 (April 2012): AB376. http://dx.doi.org/10.1016/j.gie.2012.03.991.

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Iwasaki, Akito, Yuri Kato, Takamitsu Sato, Kunihiro Hosono, Atsushi Nakajima, and Kensuke Kubota. "Tu1545 Fast and Safe Needle-knife Precut Papillotomy With Layer-By-Layer Incision in Difficult Biliary Cannulation May Not Require Pancreatic Stent Placement." Gastrointestinal Endoscopy 83, no. 5 (May 2016): AB603. http://dx.doi.org/10.1016/j.gie.2016.03.1252.

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arup choudhury, Jayanta Samanta, Gaurav Muktesh, Jahnvi Dhar, Antriksh Kumar, Jimil Shah, Pankaj Gupta, Vikas Gupta, Thakur Deen Yadav, and Rakesh Kochhar. "EUS-GUIDED RENDEZVOUS TECHNIQUE VERSUS PRECUT PAPILLOTOMY AS SALVAGE TECHNIQUE IN PATIENTS OF BENIGN BILIARY DISEASE WITH DIFFICULT BILIARY CANNULATION: A RANDOMIZED CONTROLLED TRIAL." Gastrointestinal Endoscopy 95, no. 6 (June 2022): AB542. http://dx.doi.org/10.1016/j.gie.2022.04.1296.

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Torres, Diana. "Biliary Cannulation by Precut Papillotomy to the Inaccessible Intradiverticular Papilla. Method Used in the Mederi - Major University Hospital, Reference Center for ERCP from Bogota." American Journal of Gastroenterology 106 (October 2011): S53. http://dx.doi.org/10.14309/00000434-201110002-00130.

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Manes, G., P. Di Giorgio, S. Ardizzone, F. Giannattasio, and G. Bianchi Porro. "OC1.11.5 A PROSPECTIVE RANDOMIZED STUDY ON THE SAFETY OF PRECUT PAPILLOTOMY WITH ANALYSIS OF THE FACTORS ASSOCIATED TO THE DEVELOPMENT OF COMPLICATIONS DURING ERCP." Digestive and Liver Disease 40 (March 2008): S33. http://dx.doi.org/10.1016/s1590-8658(08)60083-3.

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Kubota, Kensuke, Takamitsu Sato, Shingo Kato, Seitaro Watanabe, Kunihiro Hosono, Noritoshi Kobayashi, Kantaro Hisatomi, Nobuyuki Matsuhashi, and Atsushi Nakajima. "Needle-knife precut papillotomy with a small incision over a pancreatic stent improves the success rate and reduces the complication rate in difficult biliary cannulations." Journal of Hepato-Biliary-Pancreatic Sciences 20, no. 3 (September 20, 2012): 382–88. http://dx.doi.org/10.1007/s00534-012-0552-4.

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44

Tomic, D., M. Krstic, A. R. Pavlovic, S. Krstic, P. Dugalic, R. Jesic, and S. Knezevic. "Endoskopska ultrasonografija u holedoholitijazi." Acta chirurgica Iugoslavica 52, no. 1 (2005): 27–32. http://dx.doi.org/10.2298/aci0501027t.

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Diagnosis of choledocholithiasis is still difficult to establish and presents a great challenge in gastroenterology and surgery of biliary tract, since it requires expensive and sophisticated examining techniques. 10 to 15% of patients with symptomatic cholelithiasis were presented with choledocholithiasis as well. By EUS is possible to establish a diagnosis of choledocholithiasis with accuracy of 90 to 100% and precisely estimate dimensions of revealed stones. The main purpose of this survey is to present a great importance and many advantages of EUS as a contemporary diagnostic method. All patients were examined by Olympus equipment for endoscopic ultrasound with radial probe working with the frequency of 7,5 and 12 MHz at the Department for Endoscopic Ultrasound of the Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia. They were previously diagnosed with choledocholithiasis by ERCP method. We examined 16 patients, which were selected by estimated risk for cholelithiasis. We have tried to evaluate the importance of diameter of choledochus, defined by common ultrasonography, as well as values of alkaline phosphatase and serum GT. We defined 3 groups of patients: group no.1, with 2 patients presented with a low risk for choledocholithiasis; group no.2, with 6 patients with a moderate risk for choledocholithiasis, and group no.3, with 8 patients presented with significant risk for cholelithiasis. According to obtained results, EUS presents the most effective method for detecting of choledocholithiasis, which is sometimes even more efficient than ERCP. After choledocholithiasis is previously revealed by EUS, it is much easier to decide if some invasive method such as EPT or precut papillotomy has to be used. EUS is always recommended as a diagnostic method when it is necessary to avoid some expected complications, such as pancreatitis.
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Iwasaki, Akito, Takamitsu Sato, Kunihiro Hosono, Atsushi Nakajima, and Kensuke Kubota. "Tu1468 Early Decision to Perform a Needle-Knife Precut Papillotomy Without Pancreatic Stent Placement Could Enable Post-ERCP Pancreatitis to Be Avoided in Patients With Difficult Biliary Cannulation." Gastrointestinal Endoscopy 85, no. 5 (May 2017): AB640. http://dx.doi.org/10.1016/j.gie.2017.03.1473.

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Seifert, H., T. Wehrmann, K. Binmoeller, and W. F. Caspary. "A new baby-papillotome for primary cannulation or precut." Gastroenterology 114 (April 1998): A540. http://dx.doi.org/10.1016/s0016-5085(98)82195-1.

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47

Baysal, Birol, Hakan Akin, Omar Masri, Ali Tüzün İnce, and Hakan Senturk. "A Novel Round Insulated Tip Papillotome as an Alternative to the Classic Needle-Knife for Precut Sphincterotomy in Endoscopic Retrograde Cholangiopancreatography." Gastroenterology Research and Practice 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/972041.

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Objective. The purpose of this study was to investigate the efficacy and safety of a new round insulated tip papillotome (r-ITP) as compared to that of the classic needle-knife sphincterotome (NKS) in difficult-to-cannulate endoscopic retrograde cholangiopancreatography (ERCP) patients.Materials and Methods. Patients with no exclusion criteria and an intact papilla referred for ERCP were invited to participate in the study. “Difficult-to-cannulate” patients, defined as failure to achieve deep biliary cannulation within five minutes from the first touch of papilla, with no more than ten attempts permitted, were randomly assigned for precut sphincterotomy using either the classic NKS or r-ITP.Results. Seventy and 69 patients were randomly assigned to the NKS and r-ITP groups, respectively. The groups were comparable regarding age, sex, indications, and associated conditions. There was no statistically significant difference in terms of successful cannulation or post-ERCP complications between the two groups. Only five patients (3.6%) developed mild to moderate post-ERCP pancreatitis and two had mild bleeding. No perforations or deaths were encountered.Conclusions. Although the round insulated tip papillotome was not shown to be superior to the classic NKS concerning efficacy and safety when used by an experienced endoscopist, it remains a simple, safe, and efficacious alternative.
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Binmoeller, K. F., H. Gerke, H. Seifert, U. Seitz, M. Portis, and N. Soehendra. "Precutting (PC) using the erlangen-type precut papillotome (ET-PCP): A prospective comparative study." Gastrointestinal Endoscopy 41, no. 4 (April 1995): 389. http://dx.doi.org/10.1016/s0016-5107(05)80411-0.

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49

Lin, Lien-Fu. "Transpancreatic Precut Sphincterotomy for Biliary Access: The Relation of Sphincterotomy Size to Immediate Success Rate of Biliary Cannulation." Diagnostic and Therapeutic Endoscopy 2014 (March 10, 2014): 1–7. http://dx.doi.org/10.1155/2014/864082.

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Background. Transpancreatic precut sphincterotomy (TPS) is an option for difficult common bile duct (CBD) access, and the reports are few, with immediate success rate varying from 60 to 96%. The description of relation between the size of TPS and the immediate success rate of CBD cannulation was not found in the literature. The Aim of the Study. To evaluate the relation of large TPS to immediate success rate of CBD cannulation. Methods. A retrospective analysis was performed in prospectively collected data of 20 patients. TPS was performed with traction papillotome in the main pancreatic duct (MPD) directing towards 11 o’clock. Needle knife (NK) was used to enlarge TPS in five patients, and the other 15 cases had large TPS from the beginning of sphincterotomy. Prophylactic pancreatic stent was inserted in 18 cases, with diclofenac given in 12 cases. Results. The immediate success rate of CBD cannulation was 90% and with an eventual success rate of 100%. The failure in one immediate CBD cannulation with large TPS was due to atypical location of CBD orifice, and the other failed immediate CBD cannulation was due to inadequate size of TPS. Complications included 3 cases of post-TPS bleeding and 3 cases of mild pancreatitis. Conclusion. TPS is an effective procedure in patients with difficult biliary access and can have high immediate success rate with large TPS.
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De la Morena Madrigal, Emilio J., Isabel Rodríguez García, Ana Belén Galera Ródenas, and Elena Pérez Arellano. "Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation." Endoscopy International Open 09, no. 11 (November 2021): E1611—E1616. http://dx.doi.org/10.1055/a-1552-3202.

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Abstract Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor of alternative, simpler techniques that have not been shown to be either safer or more effective. Our goal is to test a device that provides the needle-knife papillotome (NKPT) with traction capability and which can facilitate the learning and execution of NKP. Patients and methods This was a descriptive bicentric observational study of a personal cohort of patients undergoing early NKP to analyse the efficacy and safety of the technique with a “hybrid-tome” (HT) built using the isolated core of a NKPT and a conventional canulotome. Results Over a 4-year period, we performed 43 NKPs with the HT, achieving BC in one or two steps in all cases. The 100 % technical success was matched by a 95 % clinical success rate. We recorded 11 adverse events (23 %): five hemorrhages, four pancreatitis, and two cholangitis. In addition to the objective data, we confirmed that HT facilitates alignment with the duodenal papilla and the execution of pre-cutting, especially if the papilla is intradiverticular or hidden by folds. Conclusions The HT tested seems to help trained endoscopists to perform NKP, especially in some anatomic situations, which can improve compliance with the guidelines recommended for early NKP in patients with DBC.
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