Presentations
Improve Your Cannulation Technique, by Divyesh V. Sejpal, MD
Dr. Sejpal discusses the importance of learning different cannulation techniques to increase success rates and help reduce pancreatitis risk factors. He also shares his treatment algorithm and video examples of cannulation techniques.
Overview of Biliary Cannulation, by Eric Goldberg, MD
Dr. Goldberg provides a case study demonstrating the double wire-guided cannulation technique. He also discusses selective duct cannulation, deep cannulation to facilitate therapeutic ERCP and recognizing difficult cannulation due to a patient’s anatomy.
Procedural Techniques
Animation: Jagwire™ Revolution High Performance Guidewire
Similar stiffness and pushability to the .035 inch guidewire, but in a .025 inch guidewire platform, may use as a primary and rescue guidewire.
Suspected Cholangiocarcinoma Case
The Jagwire Revolution straight tip guidewire is used to perform a pushing motion with a dynamic drill -- a to and fro motion with the fingers -- to allow passage of the tome, place stents and achieve decompression.
Acute Pancreatitis and Pancreatic Stones Case
Techniques are demonstrated using a guidewire to gain access to the pancreas and place a stent after a failed ERCP are demonstrated. The knuckling and hydrophilic properties of the Jagwire™ Revolution Guidewire optimizes safety and efficacy of this manuever.
The Jagwire™ Revolution angled tip guidewire and torque device are used to optimally place a stent deeply in the right posterior system. The torqueing device is called out as a key feature that allows for pinpointing of the stent.
A Jagwire Revolution angled guidewire is used to pass through gastric outlet obstruction and migrated duodenal stent, secondary to gastric cancer.
Difficult Cannulation with Stones
A knuckling technique using the Jagwire Revolution guidewire is used to move past a biliary duct stone for deep cannulation.
Difficult Cannulation with Papiliary Stenosis Case
A knuckling technique using the Jagwire Revolution guidewire is usesd perform a sphincterotomy on a scarred and stenotic papilla. The smooth pushability and the angled tip of this guidewire optimes safety of this manuever.
Case Studies
Sphincterotome steerability facilitates stent placement in a damaged pancreatic duct. Case features use of the TRUEtome™ Cannulating Sphincterotome.
ENDO-348208-AA October 2015