Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4166-4177
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4166
Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: Importance of the endoscopist’s expertise level
Sung Yong Han, Dong Hoon Baek, Dong Uk Kim, Chang Joon Park, Young Joo Park, Moon Won Lee, Geun Am Song
Sung Yong Han, Dong Hoon Baek, Dong Uk Kim, Chang Joon Park, Young Joo Park, Moon Won Lee, Geun Am Song, Division of Gastroenterology and Hepatology, Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Kim DU and Song GA contributed study concept and design; Park CJ and Park YJ contributed data acquisition; Han SY and Lee MW contributed data analysis and interpretation; Han SY and Baek DH contributed drafting of the manuscript; Kim DU and Song GA contributed critical revision of the manuscript.
Supported by Korea Medical Device Development Fund Grant Funded by the Korea Government the Ministry of Trade, Industry and Energy (Project Number: 9991007196), No. KMDF_PR_20200901_0066.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of the Pusan National University (approval No. H-1805-023-067).
Informed consent statement: Signed informed consent forms were waived by the Institutional Review Board of the Pusan National University.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Uk Kim, MD, PhD, Associate Professor, Division of Gastroenterology and Hepatology, Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, South Korea. amlm3@hanmail.net
Received: March 8, 2021
Peer-review started: March 8, 2021
First decision: March 27, 2021
Revised: April 5, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 16, 2021
Core Tip

Core Tip: Needle-knife fistulotomy (NKF) is used as a rescue technique for difficult cannulation. However, the data are limited regarding the use of NKF for primary biliary cannulation, especially when performed by beginners. Our retrospective study aims to assess the effectiveness and safety of primary NKF for biliary cannulation, and the role of the endoscopist’s expertise. The incidence rate of post-endoscopic retrograde cholangiopancreatography pancreatitis was significantly affected by the endoscopist’s expertise level in patients who received conventional cannulation with sphincterotomy, but not in those who received NKF. Primary NKF may be effective and safe in achieving ductal access in patients with naïve papilla, regardless of experience.