Cannulation techniques for ERCP: one size does not fit all.

摘要

Deep cannulation of the desired duct is a prerequisite for successful therapy at ERCE For most endoscopists in most practice settings, this means biliary access. Achieving deep biliary cannulation can be challenging at times for experts and novices alike. Despite refinements in standard techniques, and introduction of a plethora of new techniques, failure rates at obtaining deep selective biliary cannulation in "virgin" papillae range from less than 1% at expert tertiary centers to 10% or more in some practice settings. The consequences of failure are substantial and include repeat or alternative procedures with their own morbidity rates and extra costs. In addition, failed procedures often are associated with higher complication rates.