Primary Needle-Knife Sphincterotomy for Biliary Access in Patients at High Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

<div>Needle-knife sphincterotomy procedure. (a) The major duodenal papilla is reached with a duodenoscope. (b) The needle-knife sphincterotome is introduced to perform an incision on the infundibulum. (c) The needle tip is advanced about 3-4 mm from the sheath and moved toward the bulging portion of the common bile duct. (d) The precut incision is formed from the top of infundibulum to the papilla orifice in a downward direction. (e) The pinkish mucosa of the bile duct is visualized after the incision. (f) The CBD stones are removed successfully using a basket without expanding the incision.</div>

Gastroenterology Research and Practice

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Figure 1

Figure 1: Primary Needle-Knife Sphincterotomy for Biliary Access in Patients at High Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis 

Figure 1 | Primary Needle-Knife Sphincterotomy for Biliary Access in Patients at High Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis 