ATECHNIQUE FOR SELECTIVE CANNULATION OF THE COMMON BILE DUCT IN ENDOSCOPIC RETROGRADE CHOLANGIO-PANCREATOGRAPHY

—INSERTION OF GUIDE WIRE INTO THE PANCREATIC DUCT—

Abstract

In cases of excessed mobility or dislocation caused by diverticulum, tumor or postoperativechange such as Billroth I anastomosis, selective cannulation into comlnon bile duct may be difficult. We describe here a new technique for selective cannulation into tlle cornmon bile ducts in such condition. A guide wire was inserted into the main pallcreatic du.ct in order to control the mobility of the papilla and separate the Qrifice between commoll bile duct and, pancreaticduct. Then the other canllula was inserted into the same working channel side along the guidewire of the duodenoscope. Fixation of the papilla and calmulation of the common bile ductbecorne easier in 200f tota121 cases. No comLplications such as pancreatitis related with thisprocedure were experiellced. We concluded that this new technique is safe and effective for ERCP.