ERCP FOR INTRADIVERTICULAR PAPILLA - 2-DEVICES-IN-ONE-CHANNEL METHOD

Background: The prevalence of biliopancreatic disorders is high in pat ients with periampullary diverticula. However, endoscopic retrograde c holangiopancreatography (ERCP) in patients with the papilla deep insid e duodenal diverticula is difficult. Methods: Two patients were includ ed in this study, each with the papilla deep inside a diverticulum and in whom an initial ERCP was unsuccessful. A biopsy forceps to pinch t he duodenal mucosa distal to the papilla and pull the papilla out of t he diverticulum and a cannula were inserted into the working channel o f a duodenoscope together (the two-devices-in-one-channel method). Wit h coordination of the two instruments, cannulation of the bile duct wa s attempted. Results: In both patients ERCP was successful using this procedure and no complications followed. Conclusions:The two-devices-i n-one-channel method is useful when performing ERCP in patients with t he papilla inside juxtapapillary diverticula.