Endoscopy 2009; 41(7): 612-617
DOI: 10.1055/s-0029-1214859
Expert approach

© Georg Thieme Verlag KG Stuttgart · New York

Biliary cannulation during endoscopic retrograde cholangiopancreatography: core technique and recent innovations

M.  J.  Bourke1 , G.  Costamagna2 , M.  L.  Freeman3
  • 1Department of Gastroenterology, Westmead Hospital, Sydney, Australia
  • 2Policlinico A. Gemelli, Rome, Italy
  • 3Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, USA
Further Information

Publication History

Publication Date:
08 July 2009 (online)

Despite advances in imaging and device technology over the past decade, endoscopic retrograde cholangiopancreatography (ERCP) continues to be one of the most technically challenging interventions in endoscopy. The procedure remains compounded by two persistent problems: failure of successful biliary cannulation and post-ERCP pancreatitis (PEP). When performed outside expert high-volume centers, failed biliary cannulation may occur in up to 20 % of cases; repeated and prolonged attempts at cannulation increase the risk of pancreatitis, delay definitive therapy, and necessitate alternative therapeutic techniques with inferior safety profiles [1] [2]. Cannulation technique is believed to be a pivotal factor in the genesis of PEP and is obviously important for successful cannulation. This review will discuss some recent innovations in cannulation technique.

References

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M. BourkeMD 

Department of Gastroenterology, Westmead Hospital

Suite 106A
151 Hawkesbury Road
Westmead
Sydney
New South Wales
Australia
2145

Fax: +61-2-96333958

Email: michael@citywestgastro.com.au