{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:20:38Z","timestamp":1788603638243,"version":"build-2803163510"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The rescue techniques available for cannulation failure are few in number and have severe limitations. We recently described partial ampullary endoscopic mucosal resection (PA-EMR) as a novel technique for difficult biliary cannulation. We aimed to demonstrate the efficacy and safety of PA-EMR for patients with difficult biliary cannulation in a larger cohort.<\/jats:p><jats:p>We conducted a prospective cohort study at our tertiary care referral hospital. We recorded demographic factors, procedure-related characteristics, and adverse event rates in patients with difficult biliary cannulation who underwent PA-EMR.<\/jats:p><jats:p>Between June 2021 and June 2022, we performed 1073 consecutive endoscopic retrograde cholangiopancreatography procedures on 962 patients; 40 patients (12 male, 28 female, with a mean age of 68.1 [SD 4] years) had difficult biliary cannulation and underwent PA-EMR. Technical success was 100%, and none of the patients required a second session. None of the patients had an adverse event, and we encountered no 30-day mortality. The most typical indication was bile duct stones (60%; n = 24), followed by periampullary tumors (15%; n = 6). The total procedure time was 923 (range 392\u20131224) seconds.<\/jats:p><jats:p>PA-EMR was an effective and safe rescue technique in patients with difficult biliary cannulation.<\/jats:p>","DOI":"10.1055\/a-2546-4853","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T19:35:11Z","timestamp":1740512111000},"page":"1128-1133","source":"Crossref","is-referenced-by-count":1,"title":["Partial ampullary endoscopic mucosal resection in patients with difficult biliary cannulation: a prospective cohort study"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-5632","authenticated-orcid":false,"given":"Salih","family":"Tokmak","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine, Duzce University, Duzce, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Fuat","family":"Cetin","sequence":"additional","affiliation":[{"name":"General Surgery, Duzce University, Duzce, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullatif","family":"Sirin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine, Duzce University, Duzce, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevki","family":"Konur","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine, Duzce University, Duzce, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Torun","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Internal Medicine, Duzce University, Duzce, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"13627","DOI":"10.1038\/s41598-022-17809-5","article-title":"\u201cSalvage techniques\u201d are the key to overcoming difficult biliary cannulation in endoscopic retrograde cholangiopancreatography","volume":"12","author":"S Maruta","year":"2022","journal-title":"Sci Rep"},{"key":"ref2","first-page":"73","article-title":"Difficult biliary cannulation in endoscopic retrograde cholangiopancreatography: an overview of advanced techniques","volume":"9","author":"BM Fung","year":"2022","journal-title":"Eur Med J Hepatol 2021;"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E1758","DOI":"10.1055\/a-1534-2388","article-title":"Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation: a systematic review and meta-analysis","volume":"9","author":"E Guzm\u00e1n-Calder\u00f3n","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s00464-022-09539-6","article-title":"Feasibility and safety of partial ampullary endoscopic mucosal resection: a novel technique for difficult biliary cannulation (with video)","volume":"37","author":"S Tokmak","year":"2023","journal-title":"Surg Endosc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1055\/s-0042-108641","article-title":"Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"48","author":"PA Testoni","year":"2016","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1111\/ggi.14252","article-title":"Efficacy and safety of endoscopic retrograde cholangiopancreatography in the very elderly by using a combination of intravenous midazolam, ketamine, and pethidine","volume":"21","author":"S Tokmak","year":"2021","journal-title":"Geriatr Gerontol Int"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1177\/2050640616674837","article-title":"Endoscopic classification of the papilla of Vater. 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