{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:53:53Z","timestamp":1782842033928,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,9,20]],"date-time":"2012-09-20T00:00:00Z","timestamp":1348099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Successful precut sphincterotomy (PS) in difficult biliary cannulation (DBC) requires a large incision for deroofing the papilla. However, the high complication rate poses a substantial problem, in addition to the need for expert skills. Pancreatic stent placement could facilitate this procedure. Needle\u2010knife precut papillotomy with a small incision using a layer\u2010by\u2010layer method over a pancreatic stent (NKPP\u2010SIPS) could potentially improve the success rate and reduce the complication rate of PS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To validate the efficacy, feasibility and safety of NKPP\u2010SIPS in DBC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Therapeutic endoscopic retrograde cholangiopancreatography with a na\u00efve papilla was performed in 1619 cases between May 2004 and July 2011. We prospectively divided the patients chronologically, in terms of the period during which the procedure was performed, into two groups: group A; needle\u2010knife precut papillotomy (NKPP) performed between April 2004 and October 2006; group B; NKPP\u2010SIPS performed between November 2006 and July 2011. The success rates and complication rates were evaluated. NKPP was performed without pancreatic stent placement and the cut was made starting at the papillary orifice, extended upward over a length of more than 5\u201410 mm for deroofing the papilla. On the other hand, in NKPP\u2010SIPS, a pancreatic stent was placed initially as a guide, and to prevent post\u2010ERCP pancreatitis, the incision was begun at the papillary orifice in a layer\u2010by\u2010layer fashion and extended upward in 1\u20142 mm increments, not going beyond the oral protrusion, finally measuring less than 5 mm in length.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PS was performed in 8.3 % of the patients (134\/1619). The cannulation success rate of PS in the entire group was 94.0 % (126\/134). NKPP and NKPP\u2010SIPS were performed in 36 and 98 of the patients, respectively. There was one case of major bleeding in group A, and no severe complications in group B. The success rates of bile duct cannulation increased from 86.1 % (31\/36) in group A to 96.9 % (95\/98) in group B (<jats:italic>p<\/jats:italic> = 0.0189). The overall complication rate of PS was YC 33 % (12\/36) in group A (major bleeding 8.3 %; mild to moderate pancreatitis 19.4 %; perforation requiring surgery 2.8 %), and 7.1 % (7\/98) in group B (mild to moderate pancreatitis 6.1 %; minor perforation 1 %) (<jats:italic>p<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NKPP\u2010SIPS has significantly improved the success rate and reduced the complication rate of DBC, proving that a small incision starting at the orifice of the PS is sufficient, feasible and safe in DBC, when a pancreatic stent is inserted at the outset.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00534-012-0552-4","type":"journal-article","created":{"date-parts":[[2012,9,19]],"date-time":"2012-09-19T06:49:01Z","timestamp":1348037341000},"page":"382-388","source":"Crossref","is-referenced-by-count":37,"title":["Needle\u2010knife precut papillotomy with a small incision over a pancreatic stent improves the success rate and reduces the complication rate in difficult biliary cannulations"],"prefix":"10.1002","volume":"20","author":[{"given":"Kensuke","family":"Kubota","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamitsu","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Kato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seitaro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Hosono","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noritoshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kantaro","family":"Hisatomi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Kanto Medical Center  Shinagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Matsuhashi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Kanto Medical Center  Shinagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Yokohama City University Graduate School of Medicine  Fukuura 3\u20109, Kanazawa Yokohama 236\u20100004 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.117550"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0860-y"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-9969-x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.08.032"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1021728"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-0881-9"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(04)02463-0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(86)71921-4"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609263351302"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(91)70740-2"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609263351301"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.08.028"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1134-x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.09.024"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.345"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.09.037"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2005.05.022"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/ge.1999.v50.98593"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1033-y"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2005.04.046"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(89)72921-7"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1005476"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42614"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-814315"},{"key":"e_1_2_6_26_1","doi-asserted-by":"crossref","unstructured":"HalttumenJ 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