PRECUT: RECENT TRENDS AND DETAILED TECHNIQUE (WITH VIDEOS)

Abstract

Precut is performed in patients with difficult transpapillary biliary cannulation and is regarded as a salvage procedure performed only by expert endoscopists. Recently, the efficacy of early precut was reported from Europe, and more recently, the utility of direct (namely “primary”) precut was reported from Asia (Korea and India). Precut is recognized as a highly skilled technique for trainees; however, in near future, its utility may lead to a major turning point based on the results of these studies. Due to its highly skilled technique, precut training under expert endoscopists during endoscopic retrograde cholangiopancreatography may be provided to trainees to achieve early selective biliary cannulation. However, the details about precut, including terminology and technique have not been established. Therefore, this study defined precut-related terminology and described the related trends, selection of devices, and technique in detail.