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Endoscopic Procedures V: ERCP

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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Related Experiment Video

Updated: Apr 1, 2026

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

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

Published on: March 25, 2022

Difficult Biliary Access: Advanced Cannulation and Sphincterotomy Technique.

Anish Mammen¹, Gregory Haber²

¹Lenox Hill Hospital, 100 East 77th St., New York, NY 10075, USA.

Gastrointestinal Endoscopy Clinics of North America

|October 4, 2015

Summary

This summary is machine-generated.

Guidewire-assisted cannulation is the primary method for difficult biliary access. Techniques like precut sphincterotomy and pancreatic stents aid success, aiming for over 95% cannulation and under 5% complications during ERCP.

Keywords:

Advanced cannulation technique Biliary cannulation ERCP Guidewire-assisted cannulation Needle knife sphincterotomy Precut sphincterotomy Transpancreatic septotomy

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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

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Published on: May 2, 2025

Area of Science:

Gastroenterology
Endoscopic Procedures
Biliary Interventions

Background:

Difficult biliary cannulation presents a challenge in ERCP.
Various devices and techniques aim to improve success rates.

Purpose of the Study:

To review techniques for difficult biliary cannulation.
To establish standards for cannulation success and complication rates in ERCP.

Main Methods:

Guidewire-assisted cannulation as a first-line approach.
Application of precut sphincterotomy for difficult access.
Use of pancreatic duct stents to mitigate post-ERCP pancreatitis.

Main Results:

Guidewire technique is the preferred initial method.
Precut sphincterotomy is effective when difficulty is encountered.
Pancreatic stents reduce post-ERCP pancreatitis risk.

Conclusions:

Achieving >95% cannulation success is a key goal.
Maintaining <5% complication rates is essential for ERCP.
Endoscopists should strive for these high standards in difficult biliary cannulation.