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Related Experiment Video

Updated: May 12, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Difficult biliary access at ERCP.

Yan G Bakman1, Martin L Freeman

  • 1Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN 55455, USA.

Gastrointestinal Endoscopy Clinics of North America
|April 2, 2013
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...

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See all related articles

Endoscopic retrograde cholangiopancreatography (ERCP) enables biliary interventions. This review details advanced techniques and multimodality approaches for challenging bile duct cannulation during ERCP procedures.

Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Biliary Tract Diseases

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is crucial for diagnosing and treating biliary tract diseases.
  • Successful ERCP relies on precise cannulation of the bile duct, which can be technically challenging in some patients.

Purpose of the Study:

  • To provide an evidence-based review of techniques for achieving biliary access during ERCP.
  • To discuss the appropriate application of standard, advanced, and multimodality approaches for challenging cannulation.

Main Methods:

  • Review of existing literature on ERCP cannulation techniques.
  • Evidence-based discussion of device-assisted and advanced cannulation strategies.
  • Analysis of multimodality approaches for difficult biliary access.

Related Experiment Videos

Last Updated: May 12, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Main Results:

  • Standard cannulation techniques are often successful, but specialized devices and wire-guided methods improve success rates.
  • Advanced techniques, including needle-knife papillotomy and double-guidewire methods, are effective when standard approaches fail.
  • Multimodality strategies offer solutions for the most complex cases, maximizing the chances of successful biliary access.

Conclusions:

  • A range of techniques exists to facilitate challenging biliary cannulation during ERCP.
  • Selecting the appropriate technique based on patient anatomy and procedural difficulty is key to successful intervention.
  • These approaches enhance the utility of ERCP for a wider spectrum of biliary diseases.