Approach to biliary access in patients with altered anatomy

Alteration of the upper digestive tract or pancreatico-biliary anatomy poses a challenge for successful ERCP. The alterations can arise either after surgery or as a result of tumor or diverticulum. In this scenario, the papilla may be unreachable, or difficult to cannulate. The situation is further compounded by the lack of dedicated instruments for such procedures. EUS-guided biliary intervention and device assisted enteroscopy are two techniques which have been found to be useful for ERCP in patients with altered anatomy.
Source: Techniques in Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Source Type: research