Needle-knife precut access papillotomy versus persistence in standard techniques for difficult bile duct cannulation and sphicterotomy

Introduction: In about 5–10% of patients standard biliary cannulation and endoscopic sphincterotomy (EST) is difficult or sometimes impossible, especially in patients having impacted stone, juxtapapillary diverticulum or sphincter of Oddi dysfunction. There is still controversy as to apply needle-knife precut techniques in such cases. The aim of the present study was to retrospectively analyse the safety and efficacy of needle-knife precut access papillotomy (NKP) in our patients. Methods: During the period from 1999 to 2004, EST was performed in 1046 patients by the same endoscopist. In 224 individual cases the…