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Endoscopy 2023; 55(11): 1037-1042
DOI: 10.1055/a-2113-8952
Innovations and brief communications

Initial experience of visualized biliary cannulation during ERCP

Wei-hui Liu  ‡   ‡
1   Department 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
,
Xin-yu Huang‡   ‡
1   Department 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
,
Xiao Hu
1   Department 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
,
Pu Wang 
1   Department 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
,
Yun-chao Yang
1   Department 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
,
Pei-xi Liu
1   Department 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
,
Xiao-gang Liu 
1   Department 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
› Author AffiliationsSupported by: Key R&D Projects of Sichuan Province No. 2021YFS0375
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Biliary cannulation in ERCP: you don’t need to be a shark if you now can be sharp!Endoscopy 2023; 55(11): 1043-1044
DOI: 10.1055/a-2164-9565

Abstract

Background Selective biliary cannulation is the most challenging step in endoscopic retrograde cholangiopancreatography (ERCP) because only indirect radiographic images can be obtained. Therefore, we developed a novel endoscopic retrograde direct cholangioscopy (ERDC) technology to facilitate visible biliary cannulation.

Methods In this case series, we used ERDC to treat 21 patients with common bile duct stones who were enrolled consecutively between July 2022 and December 2022. The procedure details and complications were recorded, and all patients were followed up for 3 months after the procedure. The learning curve effect was analyzed by comparing the early and later cases.

Results Biliary cannulation was successful in all patients, and the stones were removed completely. The median (interquartile range [IQR]) time for cholangioscopy-guided biliary cannulation was 240.0 (10.0–430.0) seconds, and the median (IQR) number of cannulation procedures was 2 (1–5). Despite there being one episode of post-ERCP pancreatitis, one of cholangitis, and three patients developing asymptomatic hyperamylasemia, all of the patients recovered after symptomatic treatment, being discharged and with no serious adverse events occurring during the 3-month follow-up period. Compared with the early cases, the number of intubations and the use of guidewire guidance decreased in later cases.

Conclusion Our research confirms that ERDC is a feasible technology for biliary cannulation under direct vision.

‡ Joint first authors


Table 1 s



Publication History

Received: 28 December 2022

Accepted after revision: 20 June 2023

Accepted Manuscript online:
20 June 2023

Article published online:
17 August 2023

© 2023. Thieme. All rights reserved.

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