title: A pilot study of the novel offset-tip papillotome for selective biliary cannulation in ERCP.
abstract: BACKGROUND
  We developed a new offset-tip papillotome to facilitate biliary cannulation and reduce the incidence of unintended contrast injection into the pancreatic duct during ERCP. The aim of the present retrospective cohort study was to evaluate the utility of the novel offset-tip papillotome in achievement of biliary cannulation, and prevention of unintended contrast injection into the pancreatic duct during ERCP, compared with a standard straight-tip catheter.
  
  
  METHODS
  Patients with native papilla who required biliary ERCP were retrospectively reviewed. Biliary ERCPs were performed by two experienced endoscopists using either the offset-tip papillotome or a standard catheter. Patients in whom ERCP involved fellows in training were excluded.
  
  
  RESULTS
  Eighty-five patients were included and divided into two cohorts: The offset-tip papillotome (OT; n = 40) and the standard straight-tip cohort (ST; n = 45). Biliary cannulation success rates in OT and ST cohort were 92.5% and 88.9%, respectively. The frequency of unintended contrast injection into the pancreatic duct and time to biliary cannulation of the OT cohort during biliary cannulation were significantly less than those of the ST cohort (0.56 vs. 1.65 times and 103.3 vs. 287.9 seconds).
  
  
  CONCLUSIONS
  The novel offset-tip papillotome could reduce the incidence of unintended contrast injection into the pancreatic duct and the time to biliary cannulation.
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. himazu21@aol.com
authors.forename: Hiroo
authors.initials: H
authors.lastname: Imazu
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ikeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakutani
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sumiyama
authors.forename: Muneo
authors.initials: M
authors.lastname: Kawamura
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Shoryoku
authors.initials: S
authors.lastname: Hino
authors.forename: Tiing Leong
authors.initials: TL
authors.lastname: Ang
authors.forename: Salem
authors.initials: S
authors.lastname: Omar
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
mesh_terms: D000368:Aged; D002404:Catheterization / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D003135:Common Bile Duct / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology*; D010195:Pancreatitis / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D018709:Statistics, Nonparametric