2023 Volume 65 Issue 6 Pages 1136-1141
In ERCP, the proper identification and view of the duodenal papilla is related to the success of the procedure.
However, there are a certain number of difficult cases, and the typical one is a case with intradiverticular papilla (IDP). The presence of IDP increases the difficulty of cannulation during ERCP. For such cases, several techniques have been reported for easy cannulation.
We encountered three cases of IDP who underwent an ERCP-related procedure by traction and fixed the papilla using a traction device for ESD (multi loop traction device, MLTDⓇ).
In all the cases, the papillary orifice could not be identified initially; however, after traction and fixing, the papilla was secured in a good field of view and this allowed for cannulation.
In addition, no complications were observed after the procedure.
Therefore, we feel that this method can be effective and safe in cases of IDP with invisible orifice.
