Udd Marianne, Kylänpää Leena, Halttunen Jorma
Marianne Udd, Leena Kylänpää, Jorma Halttunen, Department of Gastrointestinal and General Surgery, Helsinki University Central Hospital, POB 340, HUS 00029, Helsinki, Finland.
World J Gastrointest Endosc. 2010 Mar 16;2(3):97-103. doi: 10.4253/wjge.v2.i3.97.
In Encoscopic Retrograde Cholangiopancreatography (ERCP), the main concern is to gain access into the bile duct while avoiding the pancreatic duct because of the risk of post-ERCP pancreatitis. Difficult cannulation is defined as a situation where the endoscopist, using his/her regularly used cannulation technique, fails within a certain time limit or after a certain number of unsuccessful attempts. Different methods have been developed to manage difficult cannulation. The most common solution is to perform a precut papillotomy either with a needle knife or with a sphincterotome with or without a guide wire. This review describes different methods to overcome cases of difficult cannulation. We will discuss the success rate and complication rates associated with different methods of reaching the biliary tract.
在经内镜逆行胰胆管造影术（ERCP）中，主要关注点是在避免进入胰管的同时进入胆管，因为存在ERCP术后胰腺炎的风险。困难插管被定义为内镜医师使用其常规插管技术在一定时间限制内或经过一定次数的不成功尝试后仍未成功的情况。已经开发出不同的方法来处理困难插管。最常见的解决方法是使用针刀或带或不带导丝的括约肌切开刀进行预切开乳头切开术。本综述描述了克服困难插管病例的不同方法。我们将讨论与不同胆管进入方法相关的成功率和并发症发生率。
