Precut sphincterotomy: A reliable salvage for difficult biliary cannulation

Table 1 Precut sphincterotomy devices

Product	Distal tip OD (F)	Tip length (mm)	Cut-wire length (mm)	Recommended guidewire size (inch)	Comments
Boston Scientific (United States)
Needle knife RX	5	NA	5	0.035	Triple lumen, shortwire
Micro knife XL	5	NA	5	0.035	Triple lumen, precut
Mediglobe (Tempe, Arizona)
Precut sphincterotome	5 or 6	NA	20 or 30	0.021-0.035	Double or tripleumen, noseless, erlange n-typesphincterotome
Needle knife	5 or 6	NA	0-15	NA	Single lumen
Olympus (Tokyo, Japan)
Triple lumen needle with clever coating	5	NA	5	0.035	Precut device
Triple lumen needle knife	5	NA	5	0.035	Precut device
Cook Medical (Winston-Salem, NC)
Huibregtse triple lumen needle knife	5	NA	4	0.035	Triple lumen, precut
Zimmon needle knife	5	NA	7	0.035	Precut device
Fusion needle knife	6	NA	4	0.035	Short-wire system

OD: Outside diameter; NA : Not available.

Table 2 Precut admission, success and complication rates (%)

Ref.	The need for precutting	Deep biliary cannulation	Precut-associated complication	Standard sphincterotomy-associated complication
Bailey et al[10]	12.8	85	14.9	6.1
Rabenstein et al[14]	30	85	7.3	6.8
Foutch et al[15]	9	90	9.8	9.7
Binmoeller et al[16]	38	100	5.5	5.1
Palm et al[17]	25	98.2	8.3	7.18
Cennamo et al[20]	20	92	8
deWeerth et al[18]	30	99	2.9	2.1

Table 3 The comparison of needle knife papillotomy and transpancreatic precut sphincterotomy (%)

Ref.	Transpancreatic precut	Needle knife precut	P value
Catalano et al[26]
Successful biliary cannulation	100	77	0.01
Complications	3.5	17.7	NS
Wang et al[27]
Successful biliary cannulation	90	90.8	NS
Complications	14.9	18.4	NS
Halttunen et al[30]
Successful biliary cannulation	97.3	7.3	< 0.001
Complications	9.3	8.2	NS

NS: Not significant.