Korean Journal of Gastrointestinal Endoscopy 2001;23(1): 53-55.
게실 내 유두에서 두 개의 카테타를 이용한 췌담관 삽관술 ( A Novel Approach for Cannulation of the Ampulla within a Diverticulum : A Two - Catheter Method )
장진석(Jin Seock Jang),박재형(Jae Hyeong Park),김진영(Jin Young Kim),정세라(Sae Ra Jung),김홍자(Hong Ja Kim),김기락(Ki Rhack Kim),이성구(Sung Koo Lee),서동완(Dong Wan Seo),김명환(Myung Hwan Kim),민영일(Young Il Min)
Abstract
cAn ampulla within a diverticulum is not rare especially in elderly patients with duct stones, but may pose a problem in identifying the papilla and properly orienting this structure for cannulation during endoscopic retrograde cholangiopancreatography. We therefore have used a new technique using the application of an additional catheter to keep the ampulla outside the diverticulum. When we pushed the duodenal fold downward and laterally with the first catheter, the ampulla was everted from the diverticulum and the hidden papilla was brought into view. Once the papilla was visible, the second catheter which was identical to the first, was advanced alongside it and inserted into the papillary orifice without difficulty. Bventually a successful Cholangiogram was obtained. With the insertion of a guidewire through the second catheter, sphincterotomy and insertion of endoscopic nasobiliary drainage tube were also performed successfully. (Korean J Gastrointest Endosc 2001;23;53-55)
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