Cannulation techniques: Biliary and pancreatic

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Optimal performance of endoscopic retrograde cholangiopancreatography requires facility with side-viewing endoscopes and consistent cannulation of the desired duct. Skilled biliary specialists achieve successful cannulation 95% to 99% of the time while experienced community endoscopists should reach cannulation rates above 90%. To achieve these cannulation rates, endoscopists must be prepared to adapt to all varieties of periampullary anatomy and pathology. Neither a rigidly defined sequence of accessories nor a progressively random attack on the papilla will maximize cannulation success, although complications may increase with these arbitrary approaches. Difficult access can usually be overcome by using basic anatomic principles to optimize endoscope position and cannula axis, and by selecting accessories based upon identified challenges. This article reviews manipulation of the visual field within the duodenum, means to optimal axes for cannulation, commonly encountered difficulties in achieving biliary access, alternative approaches to biliary access when standard cannulation is difficult, cannulation of the major and minor pancreatic ducts, and cannulation in patients with surgically altered anatomy.

Original languageEnglish (US)
Pages (from-to)17-26
Number of pages10
JournalTechniques in Gastrointestinal Endoscopy
Volume5
Issue number1
StatePublished - Jan 2003

Fingerprint

Catheterization
Endoscopes
Anatomy
Endoscopic Retrograde Cholangiopancreatography
Pancreatic Ducts
Visual Fields
Duodenum
Pathology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cannulation techniques : Biliary and pancreatic. / Petersen, Bret Thomas.

In: Techniques in Gastrointestinal Endoscopy, Vol. 5, No. 1, 01.2003, p. 17-26.

Research output: Contribution to journalArticle

@article{6e1833b358e642798433383d4cf9bef0,
title = "Cannulation techniques: Biliary and pancreatic",
abstract = "Optimal performance of endoscopic retrograde cholangiopancreatography requires facility with side-viewing endoscopes and consistent cannulation of the desired duct. Skilled biliary specialists achieve successful cannulation 95{\%} to 99{\%} of the time while experienced community endoscopists should reach cannulation rates above 90{\%}. To achieve these cannulation rates, endoscopists must be prepared to adapt to all varieties of periampullary anatomy and pathology. Neither a rigidly defined sequence of accessories nor a progressively random attack on the papilla will maximize cannulation success, although complications may increase with these arbitrary approaches. Difficult access can usually be overcome by using basic anatomic principles to optimize endoscope position and cannula axis, and by selecting accessories based upon identified challenges. This article reviews manipulation of the visual field within the duodenum, means to optimal axes for cannulation, commonly encountered difficulties in achieving biliary access, alternative approaches to biliary access when standard cannulation is difficult, cannulation of the major and minor pancreatic ducts, and cannulation in patients with surgically altered anatomy.",
author = "Petersen, {Bret Thomas}",
year = "2003",
month = "1",
language = "English (US)",
volume = "5",
pages = "17--26",
journal = "Techniques in Gastrointestinal Endoscopy",
issn = "1096-2883",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Cannulation techniques

T2 - Biliary and pancreatic

AU - Petersen, Bret Thomas

PY - 2003/1

Y1 - 2003/1

N2 - Optimal performance of endoscopic retrograde cholangiopancreatography requires facility with side-viewing endoscopes and consistent cannulation of the desired duct. Skilled biliary specialists achieve successful cannulation 95% to 99% of the time while experienced community endoscopists should reach cannulation rates above 90%. To achieve these cannulation rates, endoscopists must be prepared to adapt to all varieties of periampullary anatomy and pathology. Neither a rigidly defined sequence of accessories nor a progressively random attack on the papilla will maximize cannulation success, although complications may increase with these arbitrary approaches. Difficult access can usually be overcome by using basic anatomic principles to optimize endoscope position and cannula axis, and by selecting accessories based upon identified challenges. This article reviews manipulation of the visual field within the duodenum, means to optimal axes for cannulation, commonly encountered difficulties in achieving biliary access, alternative approaches to biliary access when standard cannulation is difficult, cannulation of the major and minor pancreatic ducts, and cannulation in patients with surgically altered anatomy.

AB - Optimal performance of endoscopic retrograde cholangiopancreatography requires facility with side-viewing endoscopes and consistent cannulation of the desired duct. Skilled biliary specialists achieve successful cannulation 95% to 99% of the time while experienced community endoscopists should reach cannulation rates above 90%. To achieve these cannulation rates, endoscopists must be prepared to adapt to all varieties of periampullary anatomy and pathology. Neither a rigidly defined sequence of accessories nor a progressively random attack on the papilla will maximize cannulation success, although complications may increase with these arbitrary approaches. Difficult access can usually be overcome by using basic anatomic principles to optimize endoscope position and cannula axis, and by selecting accessories based upon identified challenges. This article reviews manipulation of the visual field within the duodenum, means to optimal axes for cannulation, commonly encountered difficulties in achieving biliary access, alternative approaches to biliary access when standard cannulation is difficult, cannulation of the major and minor pancreatic ducts, and cannulation in patients with surgically altered anatomy.

UR - http://www.scopus.com/inward/record.url?scp=0042809818&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0042809818&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0042809818

VL - 5

SP - 17

EP - 26

JO - Techniques in Gastrointestinal Endoscopy

JF - Techniques in Gastrointestinal Endoscopy

SN - 1096-2883

IS - 1

ER -