Biliary cannulation during endoscopic retrograde cholangiopancreatography: core technique and recent innovations

Endoscopy ◽  
2009 ◽  
Vol 41 (07) ◽  
pp. 612-617 ◽  
Author(s):  
M. Bourke ◽  
G. Costamagna ◽  
M. Freeman
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation

scholarly journals Number of Endoscopic Retrograde Cholangiopancreatography Procedures Required for Short Biliary Cannulation Time

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Koichiro Mandai ◽  
Koji Uno ◽  
Yasutoshi Fujii ◽  
Takuji Kawamura ◽  
Kenjiro Yasuda
Keyword(s):  
Pancreatic Cancer ◽  
Bile Duct ◽  
Confidence Interval ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Odds Ratio ◽  
Biliary Stricture ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Malignant Biliary Stricture ◽  
Cannulation Success Rate

Background. Several previous studies assessed the competence in endoscopic retrograde cholangiopancreatography (ERCP) using the bile duct cannulation success rate. However, the cannulation time is also important, because a long cannulation time was reported to be a risk factor for post-ERCP pancreatitis. Aim. To determine the number of ERCP procedures required for short cannulation time of the bile duct. Methods. We retrospectively analyzed 605 ERCP procedures performed for bile duct cannulation in patients with native papilla at our institution between March 2012 and December 2015. The successful procedures were divided into 2 groups: group L and group S (cannulation time>15 minutes and ≤15 minutes, resp.). An analysis of the relationship among the biliary cannulation time, ERCP experience, and other factors was then conducted. Results. Multivariate analysis showed that the ERCP experience of ≤300 procedures (odds ratio, 2.080; 95% confidence interval, 1.337–3.142; P=0.001) and malignant biliary stricture due to pancreatic cancer (odds ratio, 1.912; 95% confidence interval, 1.072–3.412; P=0.028) were found to be significantly associated with a cannulation time of >15 minutes. Conclusions. Our findings suggested that an ERCP experience of ≤300 procedures and malignant biliary stricture due to pancreatic cancer were associated with prolonged biliary cannulation time.

scholarly journals Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, and Implications

2021 ◽  
pp. 64-72
Author(s):  
Brian M. Fung ◽  
Teodor C. Pitea ◽  
James H. Tabibian
Keyword(s):  
Risk Factors ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Significant Progress ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Vast Array ◽  
The Past ◽  
Increased Risk ◽  
Invasive Method ◽  
Difficult Biliary Cannulation

Over the past 50 years, endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred minimally invasive method of treating a vast array of pancreatobiliary diseases. An initial sine qua non for ERCP success is selective ductal cannulation. Despite significant progress in the optimisation of ERCP methods and accessories, selective biliary cannulation using conventional techniques remains unsuccessful in approximately 15% of native papilla cases. Furthermore, difficult biliary cannulation has been associated with an increased risk of post-ERCP pancreatitis, among other adverse events. Here, in the first of a two-part series, the authors provide a primer on standard biliary cannulation techniques and discuss the definition, risk factors, and implications of difficult biliary cannulation. The second part of the series will provide an overview of the existing advanced techniques used in cases of difficult biliary cannulation as well as the approach to their selection.

scholarly journals Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Rushikesh Shah ◽  
Emad Qayed
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Acute Cholangitis ◽  
Fluoroscopic Guidance ◽  
Ultrasound Guided ◽  
Unique Case ◽  
Endoscopic Retrograde ◽  
Biliary Decompression ◽  
Biliary Cannulation ◽  
X Ray ◽  
Life Saving

Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation. We present a unique case of life-saving emergent bedside ERCP in a severely ill patient with cholangitis and septic shock, using simple portable X-ray to confirm biliary cannulation.

scholarly journals Difficult Biliary Cannulation for Intradiverticular Papilla: Forceps Technique Revisited

2021 ◽  
Vol 07 (03) ◽  
pp. e191-e194
Author(s):  
Mahesh Kumar Goenka ◽  
Gajanan Ashokrao Rodge ◽  
Bhavik Bharat Shah ◽  
Shivaraj Afzalpurkar
Keyword(s):  
Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biopsy Forceps ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Successful Cannulation ◽  
Difficult Time ◽  
Difficult Biliary Cannulation ◽  
Simultaneous Use

AbstractPeriampullary diverticula (PAD) have been encountered in 5.9 to 18.5% of patients during all the endoscopic retrograde cholangiopancreatography (ERCP). Cannulation in the presence of PAD can sometimes be difficult, time consuming, and often requires a higher level of endoscopic skills.Several techniques have been reported to facilitate and increase the chances of successful bile duct cannulation in the presence of PAD. The two-devices in one-channel method has been sparingly used. It involves the simultaneous use of a biopsy forceps and another instrument, either a cannula or sphincterotome through the same working channel. We successfully performed ERCP in three cases, where bile duct cannulation was performed in the setting of intradiverticular papilla using two-devices in one-channel method.We feel that the two-devices in one-channel method can be very useful and positioned higher up in the algorithm for successful cannulation in patients with PAD.

Sign in / Sign up

Export Citation Format

Share Document