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Compare the Knob-tipped Knife With the Needle Knife in Difficult Biliary Cannulation

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified December 2012 by Zhaoshen Li, Changhai Hospital.
Recruitment status was:  Recruiting
Information provided by (Responsible Party):
Zhaoshen Li, Changhai Hospital Identifier:
First received: December 6, 2012
Last updated: December 7, 2012
Last verified: December 2012
The aim of the present study was to compare the efficacy and safety of the knob-tipped knife and needle knife for precut papillotomy in difficult common bile duct (CBD)cannulation.

Condition Intervention Phase
Endoscopic Retrograde Cholangiopancreatography Bile Duct Diseases Procedure: Precut papillotomy Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The Efficacy and Safety of Precut Papillotomy Using the Knob-tipped Knife and Needle Knife in Difficult Biliary Cannulation: a Randomized-controlled Trial.

Further study details as provided by Zhaoshen Li, Changhai Hospital:

Primary Outcome Measures:
  • Successful biliary cannulation rate after precut papillotomy [ Time Frame: During endoscopic retrograde cholangiopancreatography (ERCP) procedure ]

Secondary Outcome Measures:
  • Biliary cannulation time after precut papillotomy [ Time Frame: From precut papillotomy started to biliary cannulation achieved or abandoned ]

Other Outcome Measures:
  • The incidence of Early complications of endoscopic retrograde cholangiopancreatography(ERCP) including pancreatitis, hemorrhage, and perforation [ Time Frame: 7 days after ERCP ]

Estimated Enrollment: 50
Study Start Date: December 2012
Estimated Study Completion Date: December 2014
Estimated Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: the knob-tipped knife
the knob-tipped knife using for precut papillotomy in difficult CBD cannulation
Procedure: Precut papillotomy
Active Comparator: the needle knife
the needle knife using for precut papillotomy in difficult CBD cannulation
Procedure: Precut papillotomy

Detailed Description:

Precut sphincterotomy is an alternative technique used to facilitate CBD cannulation following the failure of conventional bile duct cannulation. Needle knife papillotomy is the most widely practiced precut technique. However,Pre-cutting the papilla with a needle-knife is difficult, requiring experience and dexterity to control the axis and depth of the cut. Due to the increased rate of complications associated with this procedure, including pancreatitis, hemorrhage, and perforation, it was recommended to be performed only by experienced endoscopists.

The knob-tipped knife, a novel instrument utilizing a 2mm or 1.5mm cutting knife, is usually used for endoscopic submucosal dissection (ESD). Its knob-shaped tip and nonadjustable length make the knife less likely to slip and penetrate the tissue during the resection. Since the process of precut papillotomy is similar to ESD, the precutting procedure with the knob-tipped knife may be easier to be performed, as well as be safer. The efficacy and safety of this instrument in precut papillotomy have not been reported. We therefore assessed the efficacy and safety of the knob-tipped knife in precut papillotomy in difficult CBD cannulation.


Ages Eligible for Study:   18 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • intact papilla and deep cannulation of the bile duct
  • a standard wire-guided cannulation >10 minutes, OR Pancreatic contrast injections ≥3, OR Pancreatic deep wire pass ≥5

Exclusion Criteria:

  • ampullary tumors
  • Billroth II or Roux-en-Y anatomy
  • prior endoscopic sphincterotomy(EST) or biliary stent
  • choledochoduodenal fistulae
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01745978

Contact: zhaoshen Li, MD 86-21-81873241
Contact: feng Liu, MD 86-21-81873262

Changhai Hospital, Second Military Medical University Recruiting
Shanghai, China, 200433
Contact: zhaoshen Li, MD    86-21-81873241   
Principal Investigator: zhaoshen Li, MD         
Sponsors and Collaborators
Changhai Hospital
  More Information

Responsible Party: Zhaoshen Li, Director of Gastroenterology, Changhai Hospital Identifier: NCT01745978     History of Changes
Other Study ID Numbers: changhai-121202
Study First Received: December 6, 2012
Last Updated: December 7, 2012

Additional relevant MeSH terms:
Bile Duct Diseases
Biliary Tract Diseases
Digestive System Diseases processed this record on September 21, 2017