Papillary Cannulation Facilitated by Submucosal Saline Injection into an Intradiverticular Papilla
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초록
Endoscopic retrograde cholangiopancreatography (ERCP) of the intradiverticular papilla with its invisible orifice remains challenging. Several techniques have been introduced to evert the papillary opening to facilitate cannulation. A 79-year-old woman with bile ductstones underwent ERCP, which revealed that the papilla was located inside a large diverticulum and tended to rotate inward with atrial of papillary cannulation. Submucosal papillary injection of 3 cc of normal saline was performed at 3 and 9 o’clock. Eversion andfixation of a papilla in the diverticulum with this technique allowed selective cannulation of the biliary tree. Stones were retrieved afterendoscopic papillary balloon dilation without complications. She had an uneventful post-procedural course. Our findings suggest thatsubmucosal saline injection technique is safe and effective for selective cannulation and can be recommended when cannulation is verydiffcult because of an intradiverticular papilla.
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) of the intradiverticular papilla with its invisible orifice remains challenging. Several techniques have been introduced to evert the papillary opening to facilitate cannulation. A 79-year-old woman with bile ductstones underwent ERCP, which revealed that the papilla was located inside a large diverticulum and tended to rotate inward with atrial of papillary cannulation. Submucosal papillary injection of 3 cc of normal saline was performed at 3 and 9 o’clock. Eversion andfixation of a papilla in the diverticulum with this technique allowed selective cannulation of the biliary tree. Stones were retrieved afterendoscopic papillary balloon dilation without complications. She had an uneventful post-procedural course. Our findings suggest thatsubmucosal saline injection technique is safe and effective for selective cannulation and can be recommended when cannulation is verydiffcult because of an intradiverticular papilla.
참고문헌 (20)
- Fogel EL, "Increased selective biliary cannulation rates in the setting of periampullary diverticula : main pancreatic duct stent placement followed by pre-cut biliary sphincterotomy", Gastrointest Endosc, 47, pp.396~400 (1998)
- Parlak E, "Diverticulum with papillae : does position of papilla affect technical success", Surg Laparosc Endosc Percutan Tech, 25, pp.395~398 (2015)
- Boix J, "Impact of periampullary duodenal diverticula at endoscopic retrograde cholangiopancreatography : a proposed classification of periampullary duodenal diverticula", Surg Laparosc Endosc Percutan Tech, 16, pp.208~211 (2006)
- Chen L, "Influence of periampullary diverticulum on the occurrence of pancreaticobiliary diseases and outcomes of endoscopic retrograde cholangiopancreatography", Eur J Gastroenterol Hepatol, 29, pp.105~111 (2017)
- Güitrón-Cantú A, "Difficulty to cannulate papilla of Vater in the presence of periampullary duodenal diverticulum", Rev Gastroenterol Mex, 75, pp.273~280 (2010)
- Harada H, "Submucosal injection can facilitate biliary access in patients with periampullary diverticula", Gastrointest Endosc, 84, pp.185~186 (2016)
- Altonbary AY, "Endoscopic retrograde cholangiopancreatography in periampullary diverticulum : the challenge of cannulation", World J Gastrointest Endosc, 8, pp.282~287 (2016)
- Parlak E, "Additional biliary cannulation methods in patients with juxtapapillary duodenal diverticula", Dig Dis Sci, 57, pp.2982~2987 (2012)
- Cappell MS, "Endoclips to facilitate cannulation and sphincterotomy during ERCP in a patient with an ampulla within a large duodenal diverticulum : case report and literature review", Dig Dis Sci, 60, pp.168~173 (2015)
- Fujita N, "ERCP for intradiverticular papilla: two-devices-in-one-channel method. Endoscopic retrograde cholangiopancreatography", Gastrointest Endosc, 48, pp.517~520 (1998)
- Elmunzer BJ, "Reverse guidewire anchoring of the papilla for difficult cannulation due to a periampullary diverticulum", Gastrointest Endosc, 82, pp.957~ (2015)
- Külling D, "Double endoscope method to access intradiverticular papilla", Gastrointest Endosc, 62, pp.811~812 (2005)
- Myung DS, "Cap-assisted ERCP in patients with difficult cannulation due to periampullary diverticulum", Endoscopy, 46, pp.352~355 (2014)
- Wang BC, "Entering the duodenal diverticulum : a method for cannulation of the intradiverticular papilla", World J Gastroenterol, 18, pp.7394~7396 (2012)
- Kim HJ, "A novel approach for cannulation to the ampulla within the diverticulum : double-catheter method", Endoscopy, 30, pp.S103~S104 (1998)
- Tóth E, "An alternative approach to the inaccessible intradiverticular papilla", Endoscopy, 31, pp.554~556 (1999)
- Calvo MM, "The rendezvous technique for the treatment of choledocholithiasis", Gastrointest Endosc, 54, pp.511~513 (2001)
- Tarantino I, "Endoscopic ultrasound guided biliary drainage", World J Gastrointest Endosc, 4, pp.306~311 (2012)
- Testoni PA, "Papillary cannulation and sphincterotomy techniques at ERCP : European Society of Gastrointestinal Endoscopy(ESGE)clinical guideline", Endoscopy, 48, pp.657~683 (2016)
- García-Cano J, "Use of an ultrathin gastroscope to locate a papilla hidden within a duodenal diverticulum", Endoscopy, 42(Suppl 2), pp.E96~E97 (2010)