Euroasian journal of hepato-gastroenterology

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VOLUME 14 , ISSUE 1 ( January-June, 2024 ) > List of Articles

Original Article

Combination of Precut Techniques in Difficult Biliary Cannulation

Azar Abiyev, Barış Tuzcu, Gülden Bilican, Harun Küçük, Serkan Dumanlı, Seçkin Özgül, Mustafa Ergin, Güner Kılıç, Ali Karataş, Murat Kekilli

Keywords : Difficult biliary cannulation, Needle-knife sphincterotomy, Transpancreatic septotomy

Citation Information : Abiyev A, Tuzcu B, Bilican G, Küçük H, Dumanlı S, Özgül S, Ergin M, Kılıç G, Karataş A, Kekilli M. Combination of Precut Techniques in Difficult Biliary Cannulation. Euroasian J Hepatogastroenterol 2024; 14 (1):56-59.

DOI: 10.5005/jp-journals-10018-1428

License: CC BY-NC 4.0

Published Online: 12-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Selective biliary cannulation (SBC) is a prerequisite for successful endoscopic retrograde cholangiopancreatography (ERCP). SBC has the potential to fail in as many as 20% of cases, even with skilled endoscopists. Precut incision techniques like needle-knife sphincterotomy (NKS) and transpancreatic septotomy (TPS) can be used in cases where standard cannulation techniques fail. However, these precut techniques may also fail in some cases. We aimed to evaluate the procedural success of the combined TPS + NKS technique in difficult biliary cannulation. Patients and methods: The study included 289 patients who underwent ERCP with precut techniques from 2017 to 2022. Patients were classified into the following three groups and evaluated retrospectively in terms of cannulation success, and ERCP-related adverse effects: Transpancreatic septotomy, NKS, and TPS + NKS; statistical package for the social sciences (SPSS), version 29.0, software was used to analyze the data. Results: The success rate of SBC was 69% in the TPS group, 75.3% in the NCS group, and 87% in the TPS + NCS group. There was no significant difference between the NKS and TPS + NKS groups. Cannulation success in both NKS group and NKS + TPS groups was significantly higher than in the TPS group (p < 0.001). Complication rates were similar. Conclusion: In cases where standard sphincterotomy and precut techniques fail, a second precut technique can be used. A previous TPS does not prevent NKS.

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