Tip palpation of the intraduodenal biliary segment for needle-knife fistulotomy.

ABSTRACT:

Background and aims

Needle-knife access fistulotomy (NKF) involves using a needle-knife to cut into the intraduodenal segment of the bile duct, thereby avoiding the papilla. Previous studies suggest this procedure decreases the risk of post-ERCP pancreatitis and increases successful biliary cannulation compared with conventional methods. In this case series, we introduce an advanced endoscopic technique aimed at aiding endoscopists with successful NKF and broadening use of this procedure.

Methods

Here we describe a technique in which we use the sphincterotome and needle-knife to palpate the intraduodenal biliary segment before needle-knife instrumentation. Careful dissection is then performed along this axis before achieving biliary cannulation with the sphincterotome and gu

SUBMITTER: Franz A 

PROVIDER: S-EPMC12282403 | biostudies-literature | 2025 Aug

REPOSITORIES: biostudies-literature