title: Biliary sphincter scissor for pre-cut access: preliminary experience.
abstract: BACKGROUND
  Needle-knife papillotomy is often used when selective biliary access cannot be achieved. It is difficult to perform and is associated with an increased risk of complications. Initial experience with a new device for pre-cut access is presented. This device may be easier to use and its use may be associated with a lesser risk for complications compared with other methods.
  
  
  METHODS
  The device is a miniature scissor mounted on a flexible shaft. It is used to cut the common channel and a short segment of the intrasphincteric common bile duct. The device was used if at least 4 attempts to cannulate the common duct with standard methods were unsuccessful in patients requiring biliary decompression. Data on outcomes and complications were collected.
  
  
  RESULTS
  In 8 of 12 patients, scissor pre-cut clearly facilitated common bile duct cannulation. No complications were encountered.
  
  
  CONCLUSIONS
  In this small case series, scissor pre-cut papillotomy was safe and effective. Common bile duct access was facilitated in the majority of patients studied.
authors.affiliation: Department of Gastroenterology, Lahey Clinic, Burlington, Massachusetts 01805, USA.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Heiss
authors.forename: Robert S
authors.initials: RS
authors.lastname: Cimis
authors.forename: Francis P
authors.initials: FP
authors.lastname: MacMillan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002779:Cholestasis / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care / Q000009:adverse effects* / Q000295:instrumentation*; D009803:Sphincter of Oddi / Q000601:surgery*; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects* / Q000295:instrumentation*; D013525:Surgical Instruments / Q000009:adverse effects*