顺利的胆管插管是成功进行胆道疾病内镜治疗最重要的一步。内镜下胆管造影选用带导丝的聪明切开刀,明显提高了胆管插管的成功率,然而仍有大约5%～10%的患者由于各种原因无法完成标准的胆管插管,而需采用针形切开刀进行乳头前切开或开窗术。针形切开刀的应用一定程度上提高了胆管插管的成功率,文献报道其难度和并发症也随之增加。近年来,我们对困难插管病例应用针形切开刀进行治疗,取得了较好的临床效果,现报告如下。一、资料与方法1.临床资料:2004年10月至2006年2月,我院共行内 Successful biliary intubation is the most important step in the successful management of endoscopic biliary disease. Endoscopic cholangiography using a smart incision with a guide wire significantly improves the success rate of biliary intubation, however, there are still about 5% to 10% of patients due to various reasons can not complete the standard biliary intubation, but need Needle-shaped incision for nipple incision or fenestration. The application of acupotomy knife to a certain extent, increased the success rate of biliary intubation, reported in the literature its difficulty and complications also increased. In recent years, we applied the needle-shaped incision for difficult intubation treatment and achieved good clinical results, the report is as follows. First, the data and methods 1 clinical data: October 2004 to February 2006, our hospital within the line