Precut papillotomy using a needle knife: experience in 100 patients with malignant obstructive jaundice.

BACKGROUND: Precut papillotomy enhances the success of selective bile duct cannulation. Doubts have been raised about the relative safety of the procedure. This study was undertaken to assess the success rate and complications of precut papillotomy using a needle knife. METHODS: 100 consecutive patients undergoing precut papillotomy for biliary endoprosthesis placement were studied. A needle knife was used in these patients after bile duct cannulation was not successful using other techniques. The success rate, complications and mortality were determined. RESULTS: Selective bile duct cannulation was achieved in 65 patients. There were six complications: bleeding (3), pancreatitis (2), and perforation (1). One patient died following duodenal perforation. The success rate for endoprosthesis placement was increased by 14.2% following precut papillotomy. CONCLUSIONS: Precut papillotomy enhances the success of selective bile duct cannulation, with complication rates similar to standard papillotomy.