Endoscopic sphincterotomy using isolated-tip needle-knife papillotome

Tonozuka_headshot Ryosuke Tonozuka, MD, from the Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan shares this video case “Endoscopic sphincterotomy using an isolated-tip needle-knife papillotome after Billroth II gastrectomy.”

A needle knife papillotome (NKP) has been used instead of a standard sphincterotome knife for difficult endoscopic sphincterotomy (ES) in patients with a surgically altered anatomy. However, NKP may increase the risk of post-procedure pancreatitis because its tip is more directly in contact with the pancreatic duct, causing electric damage. The newly developed papillotome isolated-tip needle knife papillotome (ITNKP) is a modified NKP that has a round tip made of sapphire to prevent electrical damage. This video describes ES using ITNKP for choledocholithiasis in a patient with a Billroth-Ⅱ gastrectomy. Tonozuka_fig
Figure 1. A, External view of an isolated-tip needle-knife papillotome (ITNKP). B, Endoscopic view of endoscopic sphincterotomy using an ITNKP.

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The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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