Elastic-band traction technique for cannulating intradiverticular papilla during endoscopic retrograde cholangiopancreatography

Abstract

An 84-year-old man attended the emergency department because of jaundice, fever, and abdominal pain. Blood tests showed an increase in conjugated bilirubin and cholestasis markers. He un-▶ Fig. 1 Endoscopic view of intradiverticular papilla.▶ Fig. 2 Elastic-band traction technique with metallic clip of intradiverticular papilla.▶ Fig. 3 Endoscopic and radioscopic view of papilla dilation.

Two-devices-in-one-channel method: a challenging cannulation of intradiverticular major papilla

“…In recent years, several adjuvant techniques have been described to overcome the challenges of cannulation of an intradiverticular papilla, that is, the use of mucosal traction with clips attached to dental floss, rubber band, and cap-assisted cannulation, or 2 devices in the same channel. 1 , 2 The 2-devices-in-1-channel method has been previously described as useful and safe for selective biliary cannulation of intradiverticular papillas. 3 Previous cases used either pediatric biopsy forceps or a duodenoscope with a wide instrument channel to allow both devices in the same channel.…”

Endoclip with traction band‐assisted traction method for endoscopic retrograde cholangiopancreatography with long oral protrusion of papilla

“…This variant has a squishy bend and a highly mobile bile duct, making cannulation difficult 2 . We previously reported the usefulness of the “ring‐shaped thread–assisted method,” 3 and several similar traction band methods have also been reported 4,5 . However, this method is difficult and requires many steps.…”