ASGE Postgraduate Course at ACG: Evidence-based Updates for the Practicing Gastroenterologist (On-Demand) | October 2021 OLPGATACG21-A Responsible Approach to Difficult Biliary Cannulation

Video Transcription

Video Summary

In this video, Dr. Peterson discusses the responsible approach to difficult biliary cannulation. He highlights the importance of biliary cannulation in ERCP procedures and the indicators for success. Dr. Peterson discusses the technical elements of cannulation and the different approaches available, such as duodenal positioning and mid-depth intubation. He also discusses the variations in intrapapillary anatomy and how they can affect the cannulation process. Dr. Peterson emphasizes the selection of cannulation devices, particularly short wire MD-controlled sphincter tome or short wire occlusion balloons. He mentions the use of wire-guided cannulation techniques and its benefits in terms of success rates and lower post-ERCP pancreatitis rates. Dr. Peterson also discusses ancillary techniques like needle-nose sphincterotomy and trans-pancreatic sphincterotomy. He concludes by presenting an approach to difficult biliary cannulation and highlights the importance of primary duct access in ERCP success.

Asset Subtitle

Bret T. Petersen, MD, MASGE

Keywords

biliary cannulation

ERCP procedures

cannulation techniques

intrapapillary anatomy

cannulation devices

wire-guided cannulation