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Biliary sphincter scissor for pre-cut access: preliminary experience.

BACKGROUND
Needle-knife papillotomy is often used when selective biliary access cannot be achieved. It is difficult to perform and is associated with an increased risk of complications. Initial experience with a new device for pre-cut access is presented. This device may be easier to use and its use may be associated with a lesser risk for complications compared with other methods.


METHODS
The device is a miniature scissor mounted on a flexible shaft. It is used to cut the common channel and a short segment of the intrasphincteric common bile duct. The device was used if at least 4 attempts to cannulate the common duct with standard methods were unsuccessful in patients requiring biliary decompression. Data on outcomes and complications were collected.


RESULTS
In 8 of 12 patients, scissor pre-cut clearly facilitated common bile duct cannulation. No complications were encountered.


CONCLUSIONS
In this small case series, scissor pre-cut papillotomy was safe and effective. Common bile duct access was facilitated in the majority of patients studied.