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Related Experiment Video

Updated: May 7, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Combined precut in difficult biliary cannulation.

Jesús Espinel-Díez, Eugenia Pinedo-Ramos, Luis Vaquero-Ayala

    Revista Espanola De Enfermedades Digestivas
    |October 5, 2013
    PubMed
    Summary
    This summary is machine-generated.

    Related Concept Videos

    Endoscopic Procedures V: ERCP01:26

    Endoscopic Procedures V: ERCP

    Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
    Patient...

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    Combined precut sphincterotomy is a safe and effective endoscopic technique for difficult bile duct cannulation. This method, involving transpancreatic followed by needle-knife sphincterotomy, achieved 100% success with no pancreatitis.

    Area of Science:

    • Gastroenterology
    • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Biliary Endoscopy

    Background:

    • Precut sphincterotomy encompasses various endoscopic techniques to access the bile duct when conventional cannulation fails.
    • Limited data exist on the comparative efficacy and safety of different precutting techniques within the same endoscopic session.
    • Combined precut sphincterotomy (CPS) involves sequential application of transpancreatic and needle-knife techniques.

    Purpose of the Study:

    • To describe the experience with combined precut sphincterotomy (CPS).
    • To compare the efficacy and safety of CPS against isolated precut techniques (needle-knife and transpancreatic).
    • To evaluate CPS in challenging bile duct cannulation scenarios.

    Main Methods:

    • A prospective study involving 247 precut sphincterotomies out of 2,390 ERCPs.

    Related Experiment Videos

    Last Updated: May 7, 2026

    Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
    07:44

    Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

    Published on: March 25, 2022

  • Patients were categorized into three groups: needle-knife, transpancreatic, and combined precut sphincterotomies.
  • Combined precut involved initial transpancreatic sphincterotomy, followed by needle-knife if access was not achieved.

    • Main Results:

    • Bile duct cannulation success rates were 100% for combined precut, 96.8% for transpancreatic, and 90.5% for needle-knife (p=0.03).
    • No significant differences in complication rates were observed among the three groups.
    • Notably, no pancreatitis occurred in the combined precut group, and all complications were managed conservatively.

    Conclusions:

    • Combined precut sphincterotomy demonstrates high safety and efficacy for difficult bile duct cannulation.
    • The sequential approach in CPS appears to be a valuable strategy in challenging ERCP cases.
    • Further research can validate these findings in larger patient cohorts.