Su1631 Needle-knife Sphincterotomy vs. Guidewire-Assisted Transpancreatic Sphincterotomy for Difficult Biliary Cannulation

2015 ◽  
Vol 81 (5) ◽  
pp. AB359
Author(s):  
Yoshiaki Kawaguchi ◽  
Tetsuya Mine
Keyword(s):  
Biliary Cannulation ◽  
Difficult Biliary Cannulation ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

scholarly journals Biliary cannulation in endoscopic retrograde cholangiography: How to tackle the difficult papilla

2021 ◽  
Author(s):  
Mark op den Winkel ◽  
Jörg Schirra ◽  
Christian Schulz ◽  
Enrico N. De Toni ◽  
Christian J. Steib ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Guide Wire ◽  
A Priori ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Increased Risk ◽  
Difficult Biliary Cannulation ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

Background: In the setting of a naïve papilla, biliary cannulation is a key step in successfully performing endoscopic retrograde cholangiography (ERC). Difficult biliary cannulation (DBC) is associated with an increased risk of post-ERCP-pancreatitis and failure of the whole procedure. Summary: Recommendations for biliary cannulation can be divided in (a) measures to reduce the likelihood of a difficult papilla-situation a priori and (b) rescue techniques in case the endoscopist is actually facing DBC. (a): careful inspection of the papillary anatomy and optimizing its accessibility by scope-positioning is fundamental. A sphincterotome in combination with a soft-tip hydrophilic guide-wire rather than a standard catheter with a standard guide-wire should be used. (b): The most important rescue techniques are needle-knife precut, double-guidewire technique and transpancreatic sphincterotomy. In few cases, anterograde techniques are needed. To this regard, the EUS-guided biliary drainage (EUS-BD) followed by rendezvous is increasingly used as an alternative to percutaneous-transhepatic biliary drainage. Key Messages: Biliary cannulation can be accomplished with alternative retrograde or less frequently by salvage-anterograde techniques, once conventional direct cannulation attempts have failed. Considering recent favorable data for the early use of transpancreatic sphincterotomy, an adopted version of the 2016 European-Society-for-Gastrointestinal-Endoscopy (ESGE)-algorithm on biliary cannulation is proposed.

Evaluation of Early Precut with Needle-Knife in Difficult Biliary Cannulation During ERCP

2013 ◽  
Vol 58 (12) ◽  
pp. 3606-3610 ◽  
Author(s):  
Jian-hong Zhu ◽  
Qiang Liu ◽  
De-qing Zhang ◽  
Huang Feng ◽  
Wei-chang Chen
Keyword(s):  
Biliary Cannulation ◽  
Difficult Biliary Cannulation ◽  
Needle Knife

211 Comparative Efficacy of the Iso-Tome ® Precut Versus Needle-Knife Precut Fistulotomy in Cases of Difficult Biliary Cannulation

2017 ◽  
Vol 85 (5) ◽  
pp. AB60
Author(s):  
Su Jung Han ◽  
Tae Hoon Lee ◽  
Sang-Heum Park ◽  
Hyun Jong Choi ◽  
Yun Nah Lee ◽  
...  
Keyword(s):  
Comparative Efficacy ◽  
Biliary Cannulation ◽  
Difficult Biliary Cannulation ◽  
Needle Knife

scholarly journals Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan

2020 ◽  
Author(s):  
Kai-Shun Liang ◽  
Chieh-Chang Chen ◽  
Wei-Chih Liao ◽  
Yu-ting Kuo ◽  
Liang-Wei Tseng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bile Duct ◽  
Adverse Events ◽  
Success Rate ◽  
University Hospital ◽  
Access Methods ◽  
Biliary Cannulation ◽  
Access Rate ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

Abstract Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF. Aims To investigate the success rate and complications of NKF and TPS in patients with difficult biliary access. Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, success rate of biliary cannulation, and the rate of adverse events were assessed. Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred. Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.

scholarly journals Different Strategies for Transpancreatic Septotomy and Needle Knife Infundibulotomy Due to the Presence of Unintended Pancreatic Cannulation in Difficult Biliary Cannulation

Gut and Liver ◽  
2015 ◽  
Vol 9 (4) ◽  
pp. 534 ◽  
Author(s):  
Yoon Jung Lee ◽  
Yun Kyung Park ◽  
Min Ji Lee ◽  
Kyu Taek Lee ◽  
Kwang Hyuck Lee ◽  
...  
Keyword(s):  
Biliary Cannulation ◽  
Difficult Biliary Cannulation ◽  
Needle Knife

scholarly journals Prospective Evaluation of Transpancreatic Sphincterotomy Comparing to Needle-knife Precut in Difficult Biliary Cannulation: Short-and Long-term Outcomes

2020 ◽  
Author(s):  
Fatema Tabak ◽  
Guo-Zhong Ji ◽  
Lin Miao
Keyword(s):  
Long Term Outcomes ◽  
Significant Difference ◽  
Difficult Biliary Cannulation ◽  
Short And Long Term ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy ◽  
Cannulation Success ◽  
Selective Cannulation

AbstractBackground/AimsTranspancreatic sphincterotomy (TPS) can be an alternative approach of biliary access in difficult cannulation cases. We aimed to prospectively evaluate the efficacy and safety of TPS compared to needle-knife precut (NKP), considering the late consequences of both techniques.MethodsA total of 122 enrolled patients have been divided into three groups based on the applied secondary cannulation techniques. Selective cannulation success, ERCP procedure findings, and immediate adverse events were compared between groups. We investigated the long-term outcomes during six-month after the procedure.ResultsSuccessful selective cannulation was achieved in 92.9% with TPS similarly to other groups. The mean procedure time was shorter in the TPS group without significant difference. Using TPS did not affect the rate of post-ERCP pancreatitis (PEP) with less frequent post-ERCP bleeding and perforation after TPS compared to NKP, without significant difference. Patients who received TPS, NKP, or both had no symptoms related to papillary stenosis or chronic pancreatitis during the follow-up period.ConclusionsUsing TPS was useful to achieve success cannulation in difficult cases with an acceptable PEP rate. Furthermore, it was associated with reducing bleeding and perforation rates comparing with NKP and no differences related to the long term consequences within the follow-up period.

scholarly journals Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan

2019 ◽  
Author(s):  
Kai-Shun Liang ◽  
Chieh-Chang Chen ◽  
Wei-Chih Liao ◽  
Yu-ting Kuo ◽  
Liang-Wei Tseng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bile Duct ◽  
Adverse Events ◽  
Complication Rate ◽  
University Hospital ◽  
Access Methods ◽  
Biliary Cannulation ◽  
Access Rate ◽  
Needle Knife ◽  
Transpancreatic Sphincterotomy

Abstract Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF. Aims To investigate the success rate and complications of NKF and TPS in patients with difficult biliary access. Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, succesfs rate of biliary cannulation, and the rate of adverse events were assessed. Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred. Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.

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