THE USE OF A TRACTION DEVICE CALLED THE S-O CLIP FACILITATED CANNULATION OF THE BILE DUCT WITH AN INTRADIVERTICULAR PAPILLA
2020 Volume 62 Issue 2 Pages 165-172
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2020 Volume 62 Issue 2 Pages 165-172
A 74-year-old man was admitted for epigastralgia. He was diagnosed with acute cholangitis and was scheduled for endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage. The major duodenal papilla with a periampullary diverticulum (PAD) was located on the right inferior rim of the diverticular orifice, and the initial ERCP was unsuccessful. The papilla faced outside of the diverticulum only when the biopsy forceps pinched and pulled the mucosa towards the anal side. Using a traction device (S-O clipTM), the papilla could be everted from the diverticular pouch to an appropriate position and selective bile duct cannulation was successfully performed.
This procedure was feasible without using a wide-channel duodenal endoscope. The S-O clip can be a beneficial adjunct to the ERCP procedure in patients with a PAD.
