Abstract
In spite of the risk of precutting-related pancreatitis, precut papillotomy is a feasible and valuable technique for enhancing bile duct cannulation when conventional methods using a standard catheter or guidewire failed. The pink intrapapillary mucosa (PIPM) of the ampulla of Vater, which consists of the mucosa of the common channel, bile duct, and pancreatic duct, is an important endoscopic landmark helpful in guiding a successful bile duct cannulation. When precut papillotomy is performed, it is recommended that the PIPM should be exposed as intact as possible and then tracked carefully, instead of hastily performing a blind incision and unintentional attempts at bile duct cannulation. This article is part of an expert video encyclopedia.
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