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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

775
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...
775
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: Aug 27, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic salvage therapy after failed biliary cannulation using advanced techniques: A concise review.

Yung-Kuan Tsou1,2, Kuang-Tse Pan2,3, Mu Hsien Lee1,2

  • 1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

World Journal of Gastroenterology
|September 26, 2022
PubMed
Summary

When initial bile duct cannulation fails during endoscopic retrograde cholangiopancreatography (ERCP), interval ERCP is a safe and effective salvage therapy. Percutaneous-transhepatic-endoscopic rendezvous (PTE-RV) and endoscopic ultrasound-assisted rendezvous (EUS-RV) are alternative options.

Keywords:
Difficult biliary cannulationEndoscopic retrograde cholangiopancreatographyEndoscopic ultrasoundIntervalPercutaneous transhepatic biliary drainageRendezvous

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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Biliary Interventions

Background:

  • Successful biliary cannulation is crucial for therapeutic endoscopic retrograde cholangiopancreatography (ERCP).
  • Failure can occur even with advanced techniques when the papilla is accessible, and there is no clear consensus on subsequent management.
  • This review addresses salvage options for difficult bile duct cannulation during ERCP.

Purpose of the Study:

  • To propose and discuss endoscopic management strategies for patients experiencing failed ERCP due to difficult bile duct cannulation.

Main Methods:

  • Review of literature on salvage endoscopic procedures following ERCP cannulation failure.
  • Analysis of success rates and adverse event profiles for interval ERCP, percutaneous-transhepatic-endoscopic rendezvous (PTE-RV), and endoscopic ultrasound-assisted rendezvous (EUS-RV).

Main Results:

  • Interval ERCP demonstrated an overall success rate of 76.3% with a 7.5% adverse event rate.
  • PTE-RV achieved an 88.7% success rate and a 13.2% adverse event rate.
  • EUS-RV reported success rates between 82%-86.1% with 13%-15.6% adverse events.

Conclusions:

  • Interval ERCP is recommended as the first-line salvage therapy due to its high success rate, low adverse event rate, and minimal resource requirements.
  • EUS-RV is a viable option when local expertise is available.
  • PTE-RV should be considered for patients requiring urgent biliary drainage.