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Updated: Aug 24, 2026
Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
Needle-knife papillotomy: a safe and effective technique in experienced hands
P Katsinelos1, K Mimidis, G Paroutoglou
1Department of Endoscopy, Central Hospital, Thessaloniki, Greece.
Background/Aims:
Results from studies evaluating needle-knife papillotomy are conflicting. The aim of this retrospective study was to assess the safety and efficacy of needle-knife papillotomy as a precut procedure to achieve biliary access during ERCP.
Methodology:
During a period of seven years, ERCP was performed 938 times. During this time, needle-knife papillotomy was carried out in 68 patients, with complete follow-up obtained in all patients. The follow-up concentrated on the safety and efficacy of the procedure and short-term complications.
Results:
Cannulation of the common bile duct was successful immediately after needle-knife papillotomy in 44 patients (66%), during a second ERCP in 18 patients (26%), and in a third ERCP in 2 patients (3%) achieving a total cannulation rate of 94%. There were no needle-knife papillotomy related deaths. Complications included bleeding in 5 patients (7%), and pancreatitis in 3 patients (4%). All complications were managed conservatively.
Conclusions:
Our experience indicates that needle-knife papillotomy is a versatile, effective and safe technique of gaining biliary access in patients in whom deep cannulation proves impossible and biliary access is considered essential.
