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ERCP cannulation of the major papilla hooded by a redundant Kerckring's fold: the technique of papillary traction and not hood elevation  Eric Wee, MBBS,

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Presentation on theme: "ERCP cannulation of the major papilla hooded by a redundant Kerckring's fold: the technique of papillary traction and not hood elevation  Eric Wee, MBBS,"— Presentation transcript:

1 ERCP cannulation of the major papilla hooded by a redundant Kerckring's fold: the technique of papillary traction and not hood elevation  Eric Wee, MBBS, MRCP, MMed  Gastrointestinal Endoscopy  Volume 77, Issue 3, Pages (March 2013) DOI: /j.gie Copyright © 2013 American Society for Gastrointestinal Endoscopy Terms and Conditions

2 Figure 1 A, Initial endoscopic view of the concealed major papilla beside a small duodenal diverticulum. B, Manipulation of the mucosa with the sphincterotome reveals only the frenulum. C, Major papilla revealed after the duodenal fold has been lifted. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2013 American Society for Gastrointestinal Endoscopy Terms and Conditions

3 Figure 2 A, Cannulation of the pancreatic duct with a sphincterotome while forceps are used to apply traction inferiorly. B, Biliary cannulation over the pancreatic stent with forceps maintaining traction to keep the papilla visible. C, Major papilla after biliary sphincterotomy. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2013 American Society for Gastrointestinal Endoscopy Terms and Conditions

4 Figure 3 A, Fluoroscopic image showing successful biliary guidewire cannulation over the pancreatic stent while the forceps is anchoring the papilla. B, Cholangiogram showing multiple large common bile duct stones. Gastrointestinal Endoscopy  , DOI: ( /j.gie ) Copyright © 2013 American Society for Gastrointestinal Endoscopy Terms and Conditions


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