Video Tip: Approach When Finding a Periampullary Diverticulum | January 2021-Approach When Finding a Periampullary Diverticulum

Video Transcription

If it's really on the rim, and a lot of them are on the rim, it's often not that difficult to cannulate. They sometimes can be inside the rim.  I find those perhaps some more difficult, and that's probably the second most common when they're kind of inside the rim, so they're away from you, you can't quite get to them.  And then it's really all about your skill and lineup, you know, you have to get a decent lineup so you can get that wire in.  I like to use a catheter and not a sphincter tone, because I think you have better tip control over a catheter and a wire, and I feel like I can maneuver better to get the  right lineup. If it's, you know, at the back of the tick, which is I think a little less common, unless  you've got, it's on an isthmus between two diverticulum, those usually aren't as difficult either. It's the ones that are kind of in the inside rim.  Sometimes you can't even see them and you have to sort of push the side of the tick around so you can open it out and find it.

Video Summary

In this video, the speaker discusses the difficulty of cannulating objects on the rim and inside the rim. They explain that cannulating objects on the rim is often not difficult, while those inside the rim can be more challenging. The speaker emphasizes the importance of skill and lineup to successfully insert a wire. They prefer using a catheter over a sphincter tone for better tip control and maneuverability. Objects at the back of the tick are less common and typically not as difficult to cannulate, but the speaker highlights the challenge of finding objects that are hidden inside the tick and may require pushing the side of the tick to locate them. No credits were mentioned.

Keywords

cannulating objects

rim cannulation

inside rim cannulation

wire insertion

catheter vs sphincter tone