Biliary sphincter scissor for pre-cut access: preliminary experience
Related Experiment Video
Updated: Oct 1, 2026
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Frederick W Heiss1, Robert S Cimis, Francis P MacMillan
1Department of Gastroenterology, Lahey Clinic, Burlington, Massachusetts 01805, USA.
Background:
Needle-knife papillotomy is often used when selective biliary access cannot be achieved. It is difficult to perform and is associated with an increased risk of complications. Initial experience with a new device for pre-cut access is presented. This device may be easier to use and its use may be associated with a lesser risk for complications compared with other methods.
Methods:
The device is a miniature scissor mounted on a flexible shaft. It is used to cut the common channel and a short segment of the intrasphincteric common bile duct. The device was used if at least 4 attempts to cannulate the common duct with standard methods were unsuccessful in patients requiring biliary decompression. Data on outcomes and complications were collected.
Results:
In 8 of 12 patients, scissor pre-cut clearly facilitated common bile duct cannulation. No complications were encountered.
Conclusions:
In this small case series, scissor pre-cut papillotomy was safe and effective. Common bile duct access was facilitated in the majority of patients studied.
