Ismail Alaa, Abdelwahab Maya M, Ozercan Mubin, Elnahas Osama, Bahcecioglu Ibrahim H, Yalniz Mehmet, Tawheed Ahmed
Faculty of Medicine, Helwan University, Cairo 11795, Egypt.
Department of Gastroenterology, Firat University, Elazig 23119, Türkiye.
World J Gastrointest Endosc. 2025 Jul 16;17(7):107810. doi: 10.4253/wjge.v17.i7.107810.
Endoscopic retrograde cholangiopancreatography (ERCP) is a vital diagnostic and therapeutic technique in evaluating and treating biliary and pancreatic disorders. Since its inception in the late 20 century, ERCP has transitioned from a mostly diagnostic instrument to a chiefly interventional procedure, owing to the emergence of less invasive imaging techniques like magnetic resonance cholangiopancreatography and endoscopic ultrasonography. Successful biliary cannulation is the most important and difficult step of the procedure. However, there are many challenges associated with cannulation, such as the anatomy of the major duodenal papilla, the direction of the common bile duct and pancreatic duct in the ampulla of Vater, the presence of periampullary diverticula, and scope position. Advanced techniques for cannulation are necessary when basic techniques fail. Double guidewire, precut methods, and transpancreatic sphincterotomy are examples of these advanced techniques. This review aims to summarize the challenges of biliary cannulation and tips for performing cannulation techniques.
内镜逆行胰胆管造影术（ERCP）是评估和治疗胆道及胰腺疾病的一项重要诊断和治疗技术。自20世纪后期问世以来，由于磁共振胰胆管造影和内镜超声等侵入性较小的成像技术的出现，ERCP已从主要的诊断工具转变为主要的介入性操作。成功的胆管插管是该操作最重要且最困难的步骤。然而，插管存在许多挑战，如十二指肠乳头的解剖结构、 Vater壶腹中胆总管和胰管的走向、壶腹周围憩室的存在以及内镜位置等。当基本技术失败时，需要采用先进的插管技术。双导丝技术、预切开方法和经胰括约肌切开术就是这些先进技术的例子。本综述旨在总结胆管插管的挑战以及实施插管技术的技巧。
