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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

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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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Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Updated: Jul 26, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Initial experience of visualized biliary cannulation during ERCP.

Wei-Hui Liu1, Xin-Yu Huang1, Xiao Hu1

  • 1Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China.

Endoscopy
|June 20, 2023
PubMed
Summary

Endoscopic retrograde direct cholangioscopy (ERDC) enables direct visualization for biliary cannulation, a challenging step in ERCP. This novel technology proved feasible and safe for common bile duct stone removal in a case series.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Biliary Interventions

Background:

  • Selective biliary cannulation in ERCP is difficult due to reliance on indirect imaging.
  • A novel endoscopic retrograde direct cholangioscopy (ERDC) technology was developed to enable direct visualization during biliary cannulation.

Purpose of the Study:

  • To evaluate the feasibility and safety of ERDC for biliary cannulation in patients with common bile duct stones.
  • To assess the learning curve effect of ERDC by comparing early and later cases.

Main Methods:

  • A case series involving 21 patients with common bile duct stones treated with ERDC between July and December 2022.
  • Detailed recording of procedure, complications, and 3-month follow-up.
  • Analysis of learning curve by comparing early and late procedural phases.

Main Results:

  • Successful biliary cannulation was achieved in all patients, leading to complete stone removal.
  • Median cannulation time was 240 seconds (IQR 10-430), with a median of 2 cannulations (IQR 1-5).
  • Low complication rates observed (1 post-ERCP pancreatitis, 1 cholangitis, 3 asymptomatic hyperamylasemia), with full recovery and no serious adverse events during follow-up. Later cases showed reduced intubations and guidewire use.

Conclusions:

  • Endoscopic retrograde direct cholangioscopy (ERDC) is a feasible technology for direct visual guidance during biliary cannulation.
  • ERDC demonstrates safety and efficacy in the management of common bile duct stones.
  • The technology shows potential for improving the challenging biliary cannulation step in ERCP.