ATYPICAL ENDOSCOPIC PAPILLOTOMY TECHNIQUE

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, to operative intraluminal endoscopy, and can be used for endoscopic papillotomy in case of technical difficulties associated with standard and/or atypical techniques; for approach to common bile duct (CBD) in diagnostic and operative transpapillary interventions. Atypical endoscopic papillotomy involves X-papillotomy ensured by lengthwise dissection of bile papilla (BP) roof with approach to submucous layers. Thereafter deeper tissues are transversely incised thus opening CBD lumen within the region limited from below with BP orifice and from above with half-distance of BP orifice and the first transverse fold of duodenum.;EFFECT: more success search and rupture of terminal CBD in technically difficult cases associated with changed BP for curing acute and chronic terminal CBD obstructions in benign and malignant diseases; thus minimising the risk of duodenum wall perforation and BP sphincter injures; one-stage intervention; diagnostic cholangiography without terminal CBD dilatation in tubular ductal systems.;13 dwg, 2 ex, 1 tbl