Korean J Gastrointest Endosc.  1999 Apr;19(2):313-317.

Application of Grasp Forceps on Selective Cannulation of Pancreatobiliary Duct in a Patient with Peripapillary Diverticulum

• Cho SW
• Kim JH
• Shin YJ
• Han DS
• Kim YJ
• Yoo BM

Abstract

During endoscopic retrograde cholangiopancreatography (ERCP), cannulation is more difficult in patients with anatomical variations, ampullary stenosis, impacted stone in the papilla, papillary cancer, peripapillary diverticulum, postoperative states such as those after Billroth II or Braun operations. In patients with peripapillary diverticulum, the position of the papilla can be modified by the presence of the diverticulum, rendering the cannu-lation more difficult. In this situation, the success rate of ERCP is lower than that in nor-mal situation. We have, therefore, used a new technique with the application of grasp forceps to expose the duodenal papilla properly during ERCP in a patient whose papilla was located on the edge of a large duodenal diverticulum and the papillary orifice was hidden behind the edge of the diverticulum.

Keyword

Endoscopic retrograde cholangiopancreatography; Peripapillary diverti-culum; Selective cannulation

MeSH Terms

Catheterization*
Cholangiopancreatography, Endoscopic Retrograde
Constriction, Pathologic
Diverticulum*
Gastroenterostomy
Hand Strength*
Humans
Surgical Instruments*