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Related Experiment Video

Updated: Nov 20, 2025

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

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Access fistulotomy: technical tips for success.

John P Magulick¹, Earl V Campbell¹, Thiruvengadam Muniraj¹

¹Department of Medicine, Division of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut.

Videogie : an Official Video Journal of the American Society for Gastrointestinal Endoscopy

|January 25, 2021

Summary

This summary is machine-generated.

Access fistulotomy is a valuable technique for achieving biliary access during ERCP. This method, when guided by key landmarks, improves success rates and procedural outcomes.

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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

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Published on: February 3, 2016

Area of Science:

Gastroenterology
Endoscopic Retrograde Cholangiopancreatography (ERCP)

Background:

Biliary cannulation is crucial for ERCP success but can be challenging.
Difficult cannulation may lead to extended hospital stays, repeat procedures, and increased costs.

Purpose of the Study:

To describe the access fistulotomy technique for biliary access.
To illustrate critical points for successful biliary access using this adjunct method.

Main Methods:

Review of three cases utilizing access fistulotomy for biliary access.
Detailed description of procedural steps, technical tips, and anatomic landmarks.

Main Results:

Successful biliary access was achieved in all three cases using fistulotomy.
Demonstration of identifying biliary structures through "onion ring" appearance and stepwise incisions.
Illustration of fistulotomy's utility in cases with distorted anatomy, such as duodenal diverticula.

Conclusions:

Access fistulotomy is an effective technique to facilitate biliary access in ERCP.
Understanding key anatomic landmarks and meticulous incision evaluation are vital for successful fistulotomy.