Efficacy of precut using the FlushKnife N-S for patients with difficult bile duct cannulation

Abstract

The FlushKnife N-S, used in endoscopic submucosal dissection (ESD), was used for precut cases in our institution. Of 856 untreated papillary cases who underwent ERCP for biliary tract procedures, 35 patients who underwent precut using the FlushKnife N-S were evaluated for treatment outcomes and complications. The FlushKnife N-S has a short tip, so the risk of gastrointestinal perforation is low. In addition, the ability to pump water from the tip may be useful for visualization of the bile duct orifice after incision. The final success rate of bile duct cannulation after precut, including reexamination, was 97.1%. Complications were observed in two cases: post-ERCP pancreatitis and bleeding were one case (2.9%) and one case (2.9%), respectively. Precut using FlushKnife N-S may be a useful technique for patients with difficult bile duct cannulation because of its potential to improve the success rate of bile duct cannulation and to reduce the risk of perforation.