Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: Importance of the endoscopist’s expertise level
Sung Yong Han, Dong Hoon Baek, Dong Uk Kim, Chang Joon Park, Young Joo Park, Moon Won Lee, Geun Am Song
Abstract
BACKGROUND: Needle-knife fistulotomy (NKF) is used as a rescue technique for difficult cannulation. However, the data are limited regarding the use of NKF for primary biliary cannulation, especially when performed by beginners. AIM: expert). METHODS: We retrospectively evaluated the records of 542 patients with naïve prominent bulging papilla and no history of pancreatitis, who underwent bile duct cannulation at a tertiary referral center. The patients were categorized according to the endoscopist's expertise level and the technique used for bile duct cannulation. We assessed the rates of successful cannulation and adverse events. RESULTS: = 0.004) was significant risk factor of PEP in those who received NKF. CONCLUSION: Primary NKF was effective and safe in patients with prominent and bulging ampulla, even when performed by less-experienced endoscopist. We need to confirm which level of endoscopist's experience is needed for primary NKF through prospective randomized study.