98%
921
2 minutes
20
An intradiverticular papilla can make biliary cannulation challenging during endoscopic retrograde cholangiopancreatography. With an accompanying video, Asano and colleagues describe their technique using a traction device to expose the papilla and a rotatable sphincterotome to align with the bile duct axis, achieving successful biliary cannulation without adverse events.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380035 | PMC |
http://dx.doi.org/10.1002/jhbp.12134 | DOI Listing |
Dig Endosc
September 2025
Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, São Paulo, Brazil.
Background: Difficult biliary cannulation is a key challenge in endoscopic retrograde cholangiopancreatography and a major risk factor for post-ERCP pancreatitis. When the pancreatic duct is unintentionally accessed, double guidewire (DGW) is the primary rescue strategy, while transpancreatic sphincterotomy (TPS) is an alternative. Previous evidence suggests that TPS may achieve higher cannulation success and lower PEP rates compared to DGW, though direct comparative data remain limited.
View Article and Find Full Text PDFAm Surg
September 2025
Ohio Health Southeastern Medical Center, Cambridge, OH, USA.
BackgroundThere has been a shift in the management of choledocholithiasis from laparoscopic common bile duct exploration to endoscopic retrograde cholangiopancreatography. This has led to an increase in hospital length of stay, costs, and specifically for rural hospitals, transfer to a tertiary center for ERCP. Given this shift of choledocholithiasis management to advanced GI endoscopists, general surgery residents are rarely performing laparoscopic transcystic common bile duct explorations.
View Article and Find Full Text PDFJACC Case Rep
August 2025
Centinela Hospital Medical Center, Inglewood, California, USA. Electronic address:
Background: Numerous reports have described the recovery of objects that have embolized to the right heart, but this is the first known report of a freely mobile catheter fragment recovered percutaneously from the left atrium.
Case Summary: The distal marker tip of an SL0 transseptal catheter fragmented after an atrial fibrillation ablation and remained as a highly mobile object within the left atrium. The successful percutaneous retrieval of this highly mobile fragment using a noncardiac general surgical instrument is presented.
Dig Dis Sci
August 2025
Peninsula HPB Unit, University Hospitals Plymouth NHS Trust, Plymouth, PL6 8DH, England, UK.
Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) is the standard treatment for bile duct stones (BDS). While reported success rates often exceed 80%, the literature rarely distinguishes between success at the index ERCP and cumulative success across multiple procedures. Moreover, definitions of ERCP success vary significantly.
View Article and Find Full Text PDFDig Dis Sci
August 2025
Department of Gastroenterology, The People's Hospital of Leshan, Southwest Medical University, Luzhou, China.
Purpose: Endoscopic retrograde cholangiopancreatography (ERCP) is the established therapeutic modality for pancreaticobiliary diseases and has traditionally been performed under fluoroscopic guidance. According to the ALARA principle (radiation exposure as low as reasonably achievable), it is justifiable to perform an ERCP with minimal radiation exposure if it can be done without increased risk, decreased efficacy or compromised efficiency. The study aimed to evaluate management of choledocholithiasis in the general population via a radiation-free (RF) approach based on peroral digital cholangioscopy (DC).
View Article and Find Full Text PDF