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Difficult Biliary Cannulation for Intradiverticular Papilla: Forceps Technique Revisited
Mahesh Kumar Goenka1, Gajanan Ashokrao Rodge1, Bhavik Bharat Shah1
1Institute of Gastrosciences & Liver, Apollo Gleneagles Hospital, Kadapara, Phool Bagan, Kankurgachi, Kolkata, West Bengal, India.
Surgery Journal (New York, N.Y.)
|August 16, 2021
Summary
The two-devices in one-channel method simplifies bile duct cannulation during endoscopic retrograde cholangiopancreatography (ERCP) in patients with periampullary diverticula (PAD). This technique enhances success rates for challenging ERCP procedures.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
Background:
- Periampullary diverticula (PAD) are found in 5.9-18.5% of patients undergoing ERCP.
- Cannulating bile ducts with PAD presents significant technical challenges, often requiring advanced endoscopic skills.
Observation:
- The two-devices in one-channel method, utilizing simultaneous instruments, is a less common technique for ERCP.
- Successful bile duct cannulation was achieved in three cases of intradiverticular papilla using this dual-instrument approach.
Findings:
- The two-devices in one-channel method proved effective for cannulating the bile duct in the presence of periampullary diverticula.
- This technique offers a viable solution for difficult ERCPs associated with intradiverticular papilla.
Implications:
- The two-devices in one-channel method may be a valuable addition to the armamentarium for managing challenging ERCP cases.
- Wider adoption of this technique could improve outcomes and reduce procedure time for patients with PAD.
