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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

883
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...
883
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Related Experiment Video

Updated: Sep 8, 2025

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
05:36

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

Published on: May 2, 2025

236

Basic and Advanced Biliary Cannulation: How Do I Do It?

Robert H Hawes1

  • 1Orlando Health Digestive Health Institute, 1335 Sligh Boulevard, 3rd Floor, Orlando, FL 33806, USA; Center for Advanced Endoscopy, Research and Education (CARE); University of Central Florida College of Medicine.

Gastrointestinal Endoscopy Clinics of North America
|June 12, 2022
PubMed
Summary
This summary is machine-generated.

Successful biliary cannulation during ERCP can be challenging due to papilla variations. Advanced techniques and access sphincterotomy offer solutions, achieving over 90% success rates for difficult cases.

Keywords:
Access sphincterotomyAdvanced techniquesCannulationGuidewire-assistedPancreatic stentPost-ERCP pancreatitisSphincterotomy

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Area of Science:

  • Gastroenterology
  • Endoscopic Retrograde Cholangiopancreatography (ERCP)

Background:

  • Biliary cannulation of the native papilla is a critical and often difficult step in ERCP procedures.
  • Standard wire-guided techniques are effective but face challenges with anatomical variations and pathologies.

Purpose of the Study:

  • To review and present advanced cannulation techniques for ERCP.
  • To highlight the efficacy of access sphincterotomy in improving cannulation rates.

Main Methods:

  • Review of established and novel techniques for biliary cannulation in ERCP.
  • Discussion of anatomical challenges and pathological conditions affecting cannulation.
  • Evaluation of the success rates associated with advanced techniques and access sphincterotomy.

Main Results:

  • Standard techniques are successful in most cases, but difficult cannulations occur.
  • Advanced cannulation techniques and access sphincterotomy significantly improve success rates.
  • These methods can achieve successful cannulation in over 90% of challenging cases.

Conclusions:

  • Advanced cannulation techniques and access sphincterotomy are essential for managing difficult biliary cannulation during ERCP.
  • Mastery of these techniques can substantially increase the overall success rate of ERCP procedures.
  • This review aims to enhance the skills of endoscopists performing ERCP.