Pancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation

Figure 1 Study flowchart. PS: Pancreatic stent; FH: Freehand; NKP: Needle-knife papillotomy.

Figure 2 Pancreatic stent-assisted needle-knife papillotomy in a patient with difficult biliary cannulation. A: Difficult biliary cannulation in a patient with periampullary diverticulum; B: Indication of the bile duct direction after pancreatic stent placement; C: Selective biliary cannulation achieved after needle-knife papillotomy.

Figure 3 Freehand needle-knife papillotomy in a patient with difficult biliary cannulation. A: Difficult biliary cannulation in a patient with periampullary diverticulum; B: The direction of the bile duct is unclear during cannulation; C: Failure of selective biliary intubation after freehand needle-knife papillotomy.