{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:26Z","timestamp":1756339406767,"version":"3.44.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Needle\u2010knife fistulotomy is an advanced technique for gaining biliary access in endoscopic retrograde cholangiopancreatography (ERCP). This study assesses the hypothesis of whether biliary stenting after needle\u2010knife fistulotomy could improve the safety of the ERCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of the medical records of patients who referred for <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content> between 2021\u20132024 was performed. All patients with na\u00efve papilla and choledocholithiasis who underwent needle\u2010knife fistulotomy were included in the study. Patients were categorized into the two groups of with and without biliary stent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 402 included patients, 331 had successful stone extraction, among whom 50 (15.1%) and 281 (84.9%) recieved and not received a biliary stent, respectively. After 1:4 propensity score matching, age, sex, difficult cannulation, and pancreatic duct cannulation were comparable between the groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Patients with biliary stent had a borderline significant lower rate of post\u2010<jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content> pancreatitis (2.3% vs. 13.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.054). No delayed perforation was observed in either groups. There were no significant differences in cholangitis and bleeding between the groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study investigating the impact of prophylactic biliary stenting after needle\u2010knife fistulotomy, suggesting that prophylactic biliary stenting after needle\u2010knife fistulotomy and successful stone removal may improve the safety of ERCP by reducing the rate of post\u2010ERCP pancreatitis. Further large\u2010scale prospective studies are warranted to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70244","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:10:32Z","timestamp":1753938632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prophylactic Biliary Stenting After Stone Clearance Improves the Safety of Needle\u2010Knife Fistulotomy: A Propensity Score\u2010Matched Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9580-2676","authenticated-orcid":false,"given":"Amir","family":"Sadeghi","sequence":"first","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0557-1278","authenticated-orcid":false,"given":"Erfan","family":"Arabpour","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-1633","authenticated-orcid":false,"given":"Mohammad","family":"Abdehagh","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0524-4373","authenticated-orcid":false,"given":"Mohammad Reza","family":"Zali","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran 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