ASGE Recognized Industry Associate (ARIA) Training Program for Medtronic | March 2025-Cannulation and Sphincterotomy

Video Transcription

Video Summary

The video discusses the key steps and considerations for conducting a successful Endoscopic Retrograde Cholangiopancreatography (ERCP). The focus is on cannulation and sphincterotomy, critical procedures for accessing the bile duct or pancreas. Emphasizing the importance of pre-procedure preparation, the speaker highlights having a proper indication for ERCP to avoid legal issues, which occur most frequently with this procedure. Comprehensive patient evaluations, including history, physical examination, and reviewing imaging, are crucial. Additionally, ensuring appropriate equipment and personnel in the operating room is vital.<br /><br />The discussion covers techniques to reduce complications such as post-ERCP pancreatitis, including administering lactated Ringer solution, rectal indomethacin, and pancreatic stenting. Proper patient positioning and laboratory evaluations are necessary, especially in cases with anatomical variations or coexisting conditions. The use of CO2 instead of air during procedures is recommended to minimize patient discomfort.<br /><br />Furthermore, various cannulation tools and techniques are described, including the choice between short wire and long wire systems based on personal preference and procedural requirements. The importance of guide wire cannulation and the proper use of pre-cut sphincterotomy in cases of difficult cannulation are also discussed. The speaker advocates understanding personal skill limitations and emphasizes patient-centered care, including knowing when to refer to more experienced professionals if necessary.

Asset Subtitle

Prabhleen Chahal, MD, FASGE

Keywords

ERCP

cannulation

sphincterotomy

post-ERCP pancreatitis

patient evaluation

guide wire cannulation

pre-cut sphincterotomy