TeXture and color enhancement Imaging-assisted precutting: 3 case reports

Abstract

Backgrounds and Aims: In ERCP, precutting is used when biliary cannulation is challenging. Precutting is a high-risk procedure that can lead to adverse events. TeXture and color enhancement Imaging (TXI) enhances texture, brightness, and color to define subtle tissue differences clearly and may be helpful in precutting. Nevertheless, there are limited video case reports demonstrating precutting using TXI. Here, we review the techniques of TXI-assisted precutting. Methods: This video article describes TXI-assisted precutting in 3 patients with obstructive jaundice resulting from cancer of the pancreatic head. The existing literature on TXI for biliopancreatic endoscopy also is reviewed. Results: In all cases, TXI helped in biliary cannulation using precutting. No adverse events were observed in any of the cases. Conclusions: Despite the roughness of the precut incision surface, TXI was found to improve visibility and significantly helped achieve biliary cannulation.