Needle knife precut papillotomy and fistulotomy for difficult biliary cannulation during endoscopic retrograde cholangiopancreatography.

Background: Although needle knife precut papillotomy and needle knife fistulotomy have been considered useful alternatives for achieving selective biliary cannulation, controversies remain regarding the technical proficiency for performing this procedure and safety concerns.

Aim: This retrospective study evaluates the feasibility and safety of combining needle knife precut papillotomy and fistulotomy (NKPPF) to assist endoscopic retrograde cholangiopancreatography (ERCP) for difficult biliary cannulation.

Methods: Data were collected and analyzed for 48 patients who underwent NKPPF between January 2008 and September 2012 at our center.