World J Gastrointest Endosc. Apr 16, 2010; 2(4): 130-137 Published online Apr 16, 2010. doi: 10.4253/wjge.v2.i4.130
Advances in endoscopic retrograde cholangiopancreatography cannulation
Emad Qayed, Ashley L Reid, Field F Willingham, Steve Keilin, Qiang Cai
Emad Qayed, Ashley L Reid, Field F Willingham, Steve Keilin, Qiang Cai, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30322, United States
Author contributions: Qayed E performed the review of the literature, the initial preparation of the paper and the final revision; Reid AL participated in discussion and writing; Willingham FF and Keilin S provided advice and participated in writing; Cai Q designed the format of the manuscript, provided guidance and participated in writing.
Correspondence to: Qiang Cai, MD, PhD, Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, Suite B1262, Atlanta, GA 30322, United States. qcai@emory.edu
Telephone: +1-404-7275638 Fax: +1-404-7275767
Received: November 19, 2009 Revised: April 1, 2010 Accepted: April 8, 2010 Published online: April 16, 2010
Abstract
Endoscopic retrograde cholangiopancreatography is an important tool in the diagnosis and treatment of pancreatobiliary diseases. A critical step in this procedure is deep cannulation of the bile duct as failure of cannulation generally results in an aborted procedure and failed intervention. Expert endoscopists usually achieve a high rate of successful cannulation while those less experienced typically have a much lower rate and a greater incidence of complications. Prolonged attempts at cannulation can result in significant morbidity to patients, anxiety for endoscopists, unnecessary radiation exposure and inefficient patient care. Here we review the most common endoscopic techniques used to achieve selective biliary cannulation. Pharmacologic aids to cannulation are also discussed briefly in this review.
