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Double Guidewire Technique (DGT) For Difficult ERCP Cannulation

Double Guidewire Technique (DGT) For Difficult ERCP Cannulation. Peter R. McNally, DO, FASGE, FACG University Colorado Denver School of Medicine Center for Human Simulation Aurora, Colorado 80045. McNally.VHJOE.ERCP.TR.2010.No4.

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Double Guidewire Technique (DGT) For Difficult ERCP Cannulation

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  1. Double Guidewire Technique (DGT)For Difficult ERCP Cannulation Peter R. McNally, DO, FASGE, FACG University Colorado Denver School of Medicine Center for Human Simulation Aurora, Colorado 80045 McNally.VHJOE.ERCP.TR.2010.No4

  2. Figure 1. Injection of contrast into the Pancreatic Duct (PD) PD Cannula Tip

  3. Fig 2. Double Guidewire Technique (DGT) Endoscopic view of guidewire in the ampullary Os. Still fluroscopic view of a guidewire in the pancreatic duct.

  4. Fig 3. Double Guidewire Technique (DGT) Endoscopic view of guidewire in ampullary Os. ERCP cannula adjacent to guidewire. ERCP scope is then rotated slightly left to visualize the ampullary Os.

  5. Fig 4. Double Guidewire Technique (DGT) With cannula gently engaged in the Os, 2nd guidewire is advanced through cannula into the CBD Still fluroscopy illustrating guidewire in PD, cannula in Os, and 2nd guidewire in CBD

  6. Fig 5. Double Guidewire Technique (DGT) Still Fluroscopy illustrating, guidewire in PD and cannula in CBD. Endoscopic view of guidewire in PD, cannula filled with yellow bile in the CBD.

  7. Fig 6. Double Guidewire Technique (DGT) Endoscopic view of guidewire in PD, cannula in CBD filled with yellow bile. Guidewire in PD, contrast injection into CBD

  8. Fig 7. Double Guidewire Technique (DGT) Endoscopic view of guidewire in PD, cannula in CBD filled with yellow bile. Additional Opacification of the CBD with contrast

  9. Double Guidewire Technique (DGT) Removal of guidewire from PD, opacification of the CBD

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