Cannulation Difficulty During ERCP Varies by Papilla Shape

In a prospective study, small, protruding, or pendulous papillae were harder to cannulate, regardless of endoscopist experience.

Over the years, many factors have been evaluated with regard to predicting outcomes of bile duct cannulation during endoscopic retrograde cholangiopancreatography (ERCP). Only recently has the actual shape of the papilla been considered as a factor meriting systematic study.

The current prospective, multicenter study is a follow-up to an earlier study by the same researchers, wherein they proposed the following schema for classifying papillae into four distinct types: regular (type 1), small (type 2), protruding or pendulous (type 3), and creased or ridged (type 4). Endoscopist experience level was categorized as expert, intermediate, or fellow.

Among 1400 patients enrolled, 98% of patients had papillae that fit into a specific type. The freq…

Reviewing Author

Douglas G. Adler, MD, FACG, AGAF, FASGE

Disclosures

Consultant/Advisory BoardBSC; Merit; Olympus

Speaker’s BureauAbbVie

Editorial BoardsGastrointestinal Endoscopy

Douglas G. Adler, MD, FACG, AGAF, FASGE

Disclosures

Consultant/Advisory BoardBSC; Merit; Olympus

Speaker’s BureauAbbVie

Editorial BoardsGastrointestinal Endoscopy

Cannulation Difficulty During ERCP Varies by Papilla Shape

Topics

Reviewing Author