ArticleEndoscopy international open2026
Transpancreatic precut sphincterotomy during ERCP: Learnability and outcomes across operator volumes and experience.
Article in Endoscopy international open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background and study aims: Transpancreatic precut sphincterotomy (TPS) is an advanced option for difficult biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP) and is thought to be easier to learn than other techniques. We assessed TPS learnability across operators with differing volumes and experience levels. Patients and methods: TPS was introduced in April 2016. We retrospectively analyzed ERCPs performed thereafter (April 2016-March 2023) by three endoscopists: high-volume senior (~80/year), low-volume senior (~30/year), and low-volume newly independent (~30/year; since October 2020). Outcomes were successful common bild duct cannulation after TPS; cannulation/total ERCP times; and adverse events, including post-ERCP pancreatitis (PEP). Results: Among 539 ERCPs in patients with naïve papillae, TPS was used in 69 procedures (12.8%; 46, 16, and 7 for the high-volume senior, low-volume senior, and newly independent operators, respectively). Cannulation success after TPS was uniformly high (95.7%, 100%, and 100%, respectively). PEP occurred in 8.7%, 6.3%, and 28.6%, respectively, all mild. The newly independent operator had longer cannulation times (median [interquartile range] 35 [15] min vs. 22 [17] and 25 [12] min; Conclusions: TPS is a readily adoptable advanced option for endoscopists proficient in basic ERCP skills. Newly independent operators can achieve comparable cannulation success but demonstrate early-proficiency patterns that may inform training, supervision, and procedure standardization.
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