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CC BY-NC-ND 4.0 · Endosc Int Open
DOI: 10.1055/a-2509-7369
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Use of the mini-forceps traction-assisted cannulation technique when standard ERCP methods fail: A single center retrospective study

Ankit Mishra 
1   Department of Internal Medicine, University of Michigan, Ann Arbor, United States (Ringgold ID: RIN1259)
,
Charles Meade
2   Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States (Ringgold ID: RIN1259)
,
Allison R Schulman
3   Division of Gastoenterology and Hepatology, University of Michigan Michigan Medicine, Ann Arbor, United States (Ringgold ID: RIN21614)
,
George Philips
4   Department of Internal Medicine/Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States (Ringgold ID: RIN1259)
,
Jorge Machicado
2   Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, United States (Ringgold ID: RIN1259)
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Introduction: There are few salvage techniques to achieve biliary cannulation when no duct can be accessed. Methods: We retrospectively reviewed 10 consecutive cases where mini-forceps traction-assisted cannulation technique (MFTAC) was used after failing any duct access during ERCP. Outcomes included: A) Technical success; B) Use of adjunct techniques; C) Time to biliary access; and D) Adverse events (AEs). Results: Most patients had a native papilla (n=9) of peri-diverticular location (n=5) and a benign indication (n=6). Standard cannulation was unsuccessful over 8:23 mm:ss (IQR 6:04-19:43). MFTAC had 100% technical success, achieved biliary access after 17:38 mm:ss (IQR 8:52-20:31), and had 10% AEs (post-ERCP pancreatitis). MFTAC was sufficient to allow biliary cannulation in 3 cases and allowed pancreatic duct access in 7 cases, which then allowed biliary cannulation with double-wire technique (5/10) and transpancreatic septotomy (2/10). Conclusion: MFTAC is a feasible salvage approach for biliary access when standard cannulation methods fail.



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Eingereicht: 26. September 2024

Angenommen nach Revision: 05. Dezember 2024

Accepted Manuscript online:
02. Januar 2025

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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